San Diego, CA USA (UroToday.com) There has always been controversy of which style of lithotripsy leads to higher stone free rates: dusting vs. basketing. There are distinct advantages and disadvantages to each. Basketing entails active stone retrieval, while dusting is a passive process in which stone fragments drain down the ureter with irrigation.
Technique type is based largely on surgeon preference, and there is currently little evidence regarding which style leads to higher stone free rates. Here, the authors present data from the Endourology Disease Group for Excellence (EDGE) consortium of eight high-volume stone centers with well-established approaches to intrarenal calculi extraction.
In the study of 152 patients (82 basketing, 70 dusting) with 5-20 mm renal stones, there was a significantly larger mean stone size in the dusting group. This group also had a significantly higher laser energy usage. Stone free rates were 86.3% and 59.2% for the basketing and dusting groups, respectively. There was no difference in the rate at which patients became symptomatic during their 3-month follow up between the two groups.
This study provides some very interesting insights into stone extraction technique. There was a large difference in stone free rate; this may or may not be attributable to the size differences. However, with short-term follow up, this difference in stone free rate did not seem to be clinically significant. While choice of technique is still based on surgeon preference, further follow up from this consortium may provide interesting insights into the clinical impact of long-term residual stone fragments.
Presented By: Mitchell Humphreys, MD
Written By: Rahul Dutta, BS; Urology Fellow, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA