Aykut Demirci has graduated from Kırıkkale University in 2008. He has completed his Urology Residency training from Dışkapı Yıldırım Beyazıt Training and Research Hospital in 2015. He is working as an Urologist at Aksaray State Hospital.
Percutaneous nephrolithotomy (PNL) and retrograde intra-renal surgery (RIRS) are the standard treatments used in the endoscopic treatment of kidney stones. The purpose of the study was to show the radiation exposure difference between the minimally invasive techniques. This is a prospective study which included 20 patients who underwent PNL, and 45 patients who underwent RIRS in our clinic between June 2014 and October 2014. The surgeries were assessed by dividing them into three steps: Step 1: The access sheath or ureter catheter placement, Step 2: Lithotripsy and collection of fragments, and Step 3: Double J catheter or re-entry tube insertion. For the PNL and RIRS groups, mean stone sizes were 30 mm (range 16-60), and 12 mm (range 7-35); mean fluoroscopy times were 337 sec. (range 200-679), and 37 sec. (range 7-351); and total radiation exposures were 142 meq (44.7 to 221), and 4.4 meq (0.2 to 30), respectively. Fluoroscopy times and radiation exposures at each step were found to be higher in the PNL group compared to the RIRS group. When assessed for the 19 PNL patients and the 12 RIRS patients who had stone sizes ≥2 cm, the fluoroscopy time in Step 1, and the radiation exposure in Steps 1 and 2 were found to be higher in the PNL group than the RIRS group (p<0.001). Although there is need for more prospective randomized studies, RIRS appears to be a viable alternate for PNL.
A Leclerc has completed his PhD from Limoges University. He has completed his Post-doctoral studies in the Department of Thoracic and Cardiovascular Surgery and Angiology from Limoges University Hospital and this has been a great opportunity for him to develop his skills in Vascular Imaging and Diseases, Interventional Phlebology, Thrombosis and Hemostasis. He is now a Hospital Practitioner in Vascular Medicine at Saint Junien’s Hospital. He has published papers in reputed journals like the European Heart Journal and participated at the European congress.
Calcifications within the inferior vena cava and renal veins are a rare diagnosis in newborns and even more in adults. The discovery of these lesions can be accidental or secondary. These calcifications have an uncertain cause and prognosis. In adults, the etiologies of this thrombosis of unusual site regroup cancer pathologies, followed by nephrotic syndrome, constitutional or acquired thrombophilia, locoregional or general infections, surgery and finally hormonal treatments or pregnancy. We report a case in a man of 55, with no particular medical history except a premature birth, admitted in vascular medicine consultation for a calcification in his left renal vein extending to the sub-hepatic inferior vena cava, discovered accidentally on a CT scan. All clinical investigations, biological and imaging in our patient failed to find such usual etiologies. Pediatric literature gives us a first draft of response, showing similar gun ball calcifications in fetus and newborns. Some maternal-fetal and birth conditions, like prematurity, have been associated with this diagnosis. In adults, these calcifications can be revealed by pulmonary embolism or other non-specific symptoms like renal failure. The found of such lesion should assess functional consequences, including renal and cardiopulmonary, and eliminate thromboembolic complication.