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Chicaud M, Kutchukian S, Doizi S, Audenet F, Berthe L, Yonneau L, Lebret T, Timsit MO, Mejean A, Candela L, Solano C, Corrales M, Duquesne I, Descazeaud A, Traxer O, Panthier F. Is " Kidney Stone Calculator" efficient in predicting ureteroscopic lithotripsy duration? A holmium:YAG and thulium fiber lasers comparative analysis. World J Urol 2024; 42:233. [PMID: 38613608 DOI: 10.1007/s00345-024-04906-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/26/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE This study aimed to evaluate the ability of Kidney Stone Calculator (KSC), a flexible ureteroscopy surgical planning software, to predict the lithotripsy duration with both holmium:YAG (Ho:YAG) and thulium fiber laser (TFL). METHODS A multicenter prospective study was conducted from January 2020 to April 2023. Patients with kidney or ureteral stones confirmed at non-contrast computed tomography and treated by flexible ureteroscopy with laser lithotripsy were enrolled. "Kidney Stone Calculator" provided stone volume and subsequent lithotripsy duration estimation using three-dimensional segmentation of the stone on computed tomography and the graphical user interface for laser settings. The primary endpoint was the quantitative and qualitative comparison between estimated and effective lithotripsy durations. Secondary endpoints included subgroup analysis (Ho:YAG-TFL) of differences between estimated and effective lithotripsy durations and intraoperative outcomes. Multivariate analysis assessed the association between pre- and intraoperative variables and these differences according to laser source. RESULTS 89 patients were included in this study, 43 and 46 in Ho:YAG and TFL groups, respectively. No significant difference was found between estimated and effective lithotripsy durations (27.37 vs 28.36 min, p = 0.43) with a significant correlation (r = + 0.89, p < 0.001). Among groups, this difference did not differ (p = 0.68 and 0.07, respectively), with a higher correlation between estimated and effective lithotripsy durations for TFL compared to Ho:YAG (r = + 0.95, p < 0.001 vs r = + 0.81, p < 0.001, respectively). At multivariate analysis, the difference was correlated with preoperative (volume > 2000 mm3 (Ho:YAG), 500-750 mm3 SV and calyceal diverticulum (TFL)), operative (fragmentation setting (p > 0.001), and basket utilization (p = 0.05) (Ho:YAG)) variables. CONCLUSION KSC is a reliable tool for predicting the lithotripsy duration estimation during flexible ureteroscopy for both Ho:YAG and TFL. However, some variables not including laser source may lead to underestimating this estimation.
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Affiliation(s)
- Marie Chicaud
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
- Service d'Urologie, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87000, Limoges, France
| | - Stessy Kutchukian
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
- Department of Urology, Poitiers University Hospital, 2 Rue de la Milétrie, 86000, Poitiers, France
| | - Steeve Doizi
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - François Audenet
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Européen George Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Laurent Berthe
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - Laurent Yonneau
- Université Versailles Saint-Quentin-Service d'Urologie, Hôpital Foch, 40 rue Worth, 92150, Suresnes, France
| | - Thierry Lebret
- Université Versailles Saint-Quentin-Service d'Urologie, Hôpital Foch, 40 rue Worth, 92150, Suresnes, France
| | - Marc-Olivier Timsit
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Européen George Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Arnaud Mejean
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Européen George Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Luigi Candela
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Catalina Solano
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- Department of Endourology, Uroclin SAS Medellin, Medellin, Colombia
| | - Mariela Corrales
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
| | - Igor Duquesne
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Université Paris Cité, 123 boulevard de Port-Royal, 75014, Paris, France
| | - Aurélien Descazeaud
- Service d'Urologie, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, 87000, Limoges, France
| | - Olivier Traxer
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - Fréderic Panthier
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
- PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France.
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Peyrottes A, Chicaud M, Fourniol C, Doizi S, Timsit MO, Méjean A, Yonneau L, Lebret T, Audenet F, Traxer O, Panthier F. Clinical Reproducibility of the Stone Volume Measurement: A " Kidney Stone Calculator" Study. J Clin Med 2023; 12:6274. [PMID: 37834918 PMCID: PMC10573675 DOI: 10.3390/jcm12196274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND An accurate estimation of the stone burden is the key factor for predicting retrograde intra-renal surgical outcomes. Volumetric calculations better stratify stone burden than linear measurements. We developed a free software to assess the stone volume and estimate the lithotrity duration according to 3D-segmented stone volumes, namely the Kidney Stone Calculator (KSC). The present study aimed to validate the KSC's reproducibility in clinical cases evaluating its inter-observer and intra-observer correlations. METHODS Fifty patients that harbored renal stones were retrospectively selected from a prospective cohort. For each patient, three urologists with different experience levels in stone management made five measurements of the stone volume on non-contrast-enhanced computed tomography (NCCT) images using the KSC. RESULTS the overall inter-observer correlation (Kendall's concordance coefficient) was 0.99 (p < 0.0001). All three paired analyses of the inter-observer reproducibility were superior to 0.8. The intra-observer variation coefficients varied from 4% to 6%, and Kendall's intra-observer concordance coefficient was found to be superior to 0.98 (p < 0.0001) for each participant. Subgroup analyses showed that the segmentation of complex stones seems to be less reproductible. CONCLUSIONS The Kidney Stone Calculator is a reliable tool for the stone burden estimation. Its extension for calculating the lithotrity duration is of major interest and could help the practitioner in surgical planning.
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Affiliation(s)
- Arthur Peyrottes
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Marie Chicaud
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
- Service d’Urologie, CHU de Limoges, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Cyril Fourniol
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Steeve Doizi
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
| | - Marc-Olivier Timsit
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Arnaud Méjean
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Laurent Yonneau
- Service d’Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150 Suresnes, France; (L.Y.); (T.L.)
| | - Thierry Lebret
- Service d’Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150 Suresnes, France; (L.Y.); (T.L.)
| | - François Audenet
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Olivier Traxer
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
| | - Frederic Panthier
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
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