La combinación de litotricia extracorpórea y ureterorrenoscopia flexible optimiza el tratamiento de litiasis renales / Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy

Objetivos: Describir nuestra experiencia inicial en el tratamiento de las litiasis renales mediante litotricia extracorpórea controlada por ureterorrenoscopia flexible simultánea y combinada con litotricia mediante láser holmium. Material y métodos: Llevamos a cabo esta novedosa técnica en una paciente previamente seleccionada que presentaba litiasis renales izquierdas, 2 en cáliz superior, 2 en cáliz medio y 2 en cáliz inferior, la mayor de ellas en cáliz medio de 6 mm. Realizamos de forma simultánea una litotricia extracorpórea por ondas de choque y una ureterorrenoscopia flexible para un mejor control de la fragmentación de la litiasis y aplicando láser holmium. En el postoperatorio inmediato se realizó una ecografía y una tomografía computarizada (TC) de control al mes. Resultados: Se consiguió la completa fragmentación de todas las litiasis y se dejó un catéter doble J que se retiró posteriormente tras la comprobación de la ausencia de restos litiásicos mediante TC. No hubo complicaciones intraoperatorias, ni posquirúrgicas. Conclusiones: Esta técnica descrita es novedosa, segura y reproducible. El buen resultado obtenido mediante esta técnica combinada aumenta nuestro interés en seguirla empleando y considerarla como una opción de tratamiento para las litiasis renales de nuestros pacientes

Objective: Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy. Material and methods: We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6 mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done. Results: The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described. Conclusions: The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients

Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy. / La combinación de litotricia extracorpórea y ureterorrenoscopia flexible optimiza el tratamiento de litiasis renales.

OBJECTIVE: Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy. MATERIAL AND METHODS: We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done. RESULTS: The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described. CONCLUSIONS: The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients.