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Master Thesis

Traitement chirurgical des volumineux calculs rénaux : comparaison des résultats de l’urétéroscopie souple et de la mini-percutanée dans un objectif de développement d’une filière lithiase urinaire au CHU de Grenoble

Abstract : Introduction: Urolithiasis is a common and recurrent pathology. In a desire to set up a urinary lithiasis program at Grenoble University Hospital, the aim of this study was to evaluate the results of flexible ureteroscopy and miniNLPC for the treatment of large renal stones. Material and methods: This is a bi-centric retrospective descriptive study performed at Grenoble and Lyon University hospitals from January 2016 to June 2019. All patients with one or more stones of the lower pole of the kidney between 10 and 40 mm and treated by flexible ureteroscopy or miniNLPC were included. Results: 115 miniNLPC procedures and 118 URS procedures were included. The rate of patients with no significant residual fragment following a procedure was significantly higher in the miniNLPC group than in the URS group (69% vs. 52%, p <0.001). The overall postoperative complication rate was significantly higher in the miniNLPC group than in the URS group (23% vs 11%, p = 0.01). A new intervention for treatment of residual fragments was necessary for 9.6% of patients in the miniNLPC group against 30.5% of patients in the URS group (p <0.001). CONCLUSION: MiniNLPC and flexible ureteroscopy are two effective mini-invasive techniques for the treatment of large renal stones. The miniNLPC remains the most effective technique despite a higher risk of complications. This is the first line surgical treatment for stones of more than 20mm and more than 1000 HU. Flexible ureteroscopy is an interesting alternative because of its low complication rate and its feasibility as an outpatient.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02303238
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Submitted on : Wednesday, October 2, 2019 - 10:11:53 AM
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Stanislas Grisard. Traitement chirurgical des volumineux calculs rénaux : comparaison des résultats de l’urétéroscopie souple et de la mini-percutanée dans un objectif de développement d’une filière lithiase urinaire au CHU de Grenoble. Médecine humaine et pathologie. 2019. ⟨dumas-02303238⟩

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