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Related Experiment Videos

Changing indications of open stone surgery.

Brian R Matlaga1, Dean G Assimos

  • 1Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1094, USA.

Urology
|April 3, 2002
PubMed
Summary

Open stone surgery is now rare, mainly for complex cases with anatomical issues. Advances in minimally invasive treatments have significantly reduced the need for open procedures in urinary stone management.

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Area of Science:

  • Urology
  • Surgical Innovation
  • Nephrolithiasis Management

Background:

  • Open surgical treatment for urinary calculi was historically common.
  • Minimally invasive techniques for urinary stone removal have advanced significantly since 1989.
  • This study compares current open surgery rates to historical data at a single institution.

Purpose of the Study:

  • To evaluate the contemporary role of open stone surgery.
  • To compare current indications for open surgery with historical data.
  • To assess the impact of technological advancements on surgical treatment of urinary calculi.

Main Methods:

  • Retrospective review of 986 procedures for stone removal/fragmentation (1998-2001).
  • Comparison with historical institutional data from the initial 19 months post-Dornier HM3 lithotriptor introduction.
  • Analysis of indications for open surgical procedures.

Main Results:

  • Open surgical procedures decreased from 4.1% historically to 0.7% in the current period.
  • Current open surgeries are primarily for anatomic indications (85.8%) or failed endoscopic treatment (14.2%).
  • Historically, open surgery was equally split between failed endoscopic treatment (48.6%) and anatomic indications (48.7%).

Conclusions:

  • Open stone surgery remains a viable option for select patients with complex calculous disease.
  • Technological progress and surgical skill enhancement have drastically reduced the necessity for open stone surgery.
  • The primary indications for open surgery are now complex stones coupled with anatomical abnormalities.

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