A Comparative Study between Dusting and Fragmentation in Intracorporeal Laser Lithotripsy in Distal Ureteric Stone

Mostafa  H. Alawi Al Sunboli; Mohammed  B. Ismail; Raghib  J. Hameed

doi:10.32007/jfacmedbagdad.2018

Authors

Mostafa H. Alawi Al Sunboli Department of Biochemistry, College of Medicine, University of Baghdad, Baghdad, Iraq. https://orcid.org/0000-0003-2548-1384
Mohammed B. Ismail Department of Urology Surgical Specialty Hospital, Medical City Complex, Baghdad, Iraq https://orcid.org/0000-0003-3310-0000
Raghib J. Hameed Department of Biochemistry, College of Medicine, University of Baghdad, Baghdad, Iraq.

DOI:

https://doi.org/10.32007/jfacmedbagdad.2018

Keywords:

Dusting, fragmentation,, Laser lithotripsy, , lower ureteric stone.

Abstract

Background: Ureteric stones, commonly have an impact on the quality of life of the patient. There are many treatment choices for the condition including medical treatment, extra-corporeal shock wave lithotripsy (ESWL), endoscopic intervention by ureteroscope (URS), or surgery (open or laparoscopic). Semi-rigid URS with laser lithotripsy is used to fragment ureteric stones especially those in the distal ureter.

Objectives: To assess the efficacy and complications of the dusting versus the fragmentation method for lower ureteric stones using holmium laser lithotripsy by analyzing intra-operative and post-operative variables.

Patients and Methods: One hundred and twenty patients with distal ureteric stones were included in the current study which was conducted in Ghazi AL-Hariri Teaching Hospital for Surgical Specialties during the period from December 2020 to July 2022. The cases were divided into two groups: The dusting group and the fragmentation group. Both groups are further subdivided into the 10-15 mm stone group and the < 10 mm stone groups. The time of the operation, the rate of being stone-free, stone size, the rate of double-J stents (DJS), and intraoperative complications were compared for the study groups.

Results: the operative time was more among Group A (dusting) than in Group B (fragmentation) with statically significant association, with a stone-free rate more in Group A (dusting) than in Group B (fragmentation) without a statically significant Need for DJ more in group b (fragmentation) than group a (dusting) with statically significant association Regard intraoperative complication (mucosal injury, stone migration, perforation) more in group b (fragmentation)than group a (dusting) without any significant association

Conclusion: The dusting method resulted in fewer intraoperative complications (mucosal injury, stone migration, perforation) and a lower need for DJ insertion than the fragmentation method. However, it needed a longer operative time than the fragmentation method.

Received: Nov, 2022

Revised: Nov.2023

Accepted: April, 2023

Published: Oct.2023

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