Use 3D printing technology to enhance stone free rate in single tract percutaneous nephrolithotomy for the treatment of staghorn stones

Introduction: We compare percutaneous nephrolithotomy (PCNL) and open surgery in the treatment of staghorn stones in children.Methods: We retrospectively reviewed the electronic records of children who underwent treatment for staghorn stones between September 2000 and August 2013. They were divided between Group 1 (patients who underwent PCNL) and Group 2 (patients who underwent open surgery). We compared stone-free and complications rates, need for multiple procedures, and hospital stay.Results: The study included 41 patients (35 boys and 6 girls), with mean age 7.4 ± 3.1 years (range: 2–15). Of these 41 patients, 26 had unilateral renal stone and 15 had bilateral renal stones. The total number of treated renal units was 56: 28 underwent PCNL and 28 underwent open surgery. The complication rate was comparable for both groups (32% for open surgery vs. 28.6%, p = 0.771). Multiple procedures were more needed in PCNL group (60.7% vs. 32% in open surgery, p = 0.032). The stone-free rate was 71.4% after PCNL and 78.6% after open surgery (p = 0.537). A significant difference was observed in shorter hospital stay after PCNL (5 vs. 8.8 days, p < 0.001). Our study’s limitations include its retrospective design and relatively small sample size.Conclusions: For the treatment of staghorn stones in children, PCNL was comparable to open surgery in complication and stone-free rates. PCNL had the advantage of a shorter hospital stay and open surgery showed a decreased need for multiple procedures.

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Differences Effectiveness of Percutaneous Nephrolithotomy and Open Surgery in Staghorn Stone Patients: Systematic Review

Health Notions ◽

10.33846/hn41106 ◽

2020 ◽

Vol 4 (11) ◽

pp. 381-385

Author(s):

Ramandita Duta Dewangga ◽

Tarmono Djojodimedjo ◽

Dyah Erawati

Keyword(s):

Systematic Review ◽

Percutaneous Nephrolithotomy ◽

Open Surgery ◽

Meta Analysis ◽

Number Of Patients ◽

Stone Free Rate ◽

Additional Therapy ◽

Staghorn Stone ◽

Free Rate ◽

Staghorn Stones

This study purpose to analyze the differences in the effectiveness of PCNL and open surgery in patients with staghorn stones. We searched the literatures from PubMed and ScienceDirect from year 2005 until 2020. The method used in this study was a systematic review with a quantitative statistical approach (meta-analysis) using primary research data. From 4 studies there were 148 cases of PCNL and 98 cases of open surgery. PCNL had lower postoperative stone-free rate than open surgery (OR 0.168). PCNL had a lower final stone-free rate than open surgery (OR 0.603). The number of patients who had complications with PCNL was lower than open surgery (OR 0.451). The number of patients receiving blood transfusions on PCNL was lower than for open surgery (OR 0.494). Patients who received PCNL procedure required a shorter hospital stay than open surgery (MD -3,234). The number of patients who received additional therapy modalities on PCNL was lower than open surgery (OR 1.917). The conclusions obtained in this study indicate that there are differences in the effectiveness of PCNL and open surgery for patients with staghorn stones. Keywords: percutaneous nephrolithotomy; open surgery; staghorn stone

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A 3D Printing Personalized Percutaneous Nephroscope Puncture Guide Plate in Percutaneous Nephrolithotomy: A Pilot Study

10.21203/rs.3.rs-724657/v1 ◽

2021 ◽

Author(s):

Gao Keyu ◽

Li Shuaishuai ◽

Ashok raj ◽

Li Shuofeng ◽

Liu Shuai ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Percutaneous Nephrolithotomy ◽

Color Doppler ◽

Control Group ◽

Intraoperative Blood Loss ◽

Printing Technology ◽

3D Printing Technology ◽

Guide Plate ◽

Significant Difference

Abstract Objective Using CTU, combined with 3D printing technology, digital design, the development of individualized PCNL) puncture guides, preliminary discussion of its feasibility for PCNL puncture positioning.Methods Twenty-two patients with renal calculi who underwent PCNL in the hospital of Xuzhou Medical University in 2017-2018, including 10 experimental groups, used 3D printing technology to make guides (puncture guides); simulated punctures in vitro, after clearing the needle angle, PCNL was performed in 10 patients and PCNL in 12 patients in the control group. The accuracy of puncture positioning, puncture time and intraoperative blood loss were compared between the two groups.Results In the experimental group, 10 patients had good puncture guide plate and the patient's skin. The puncture needle was puncture under the guidance of the guide plate and verified by the color Doppler. The 1 needle puncture was successful 100.00% (10/10), the positioning of the needle point, the depth of the puncture. The angles were consistent with the preoperative design. The success rate of 12 cases of color Doppler ultrasound in the control group was 75.00% (9/12). There was no significant difference between the two groups (P>0.05). The amount of hemorrhage was (7.78±0.94) min and (49.31±6.43) mL, respectively. The control group was (9.04±1.09) min and (60.08±12.18) mL, respectively. The two groups were statistically significant (P<0.05). Conclusion 3D printing personalized percutaneous nephrolithotomy guide can improve the accuracy of PCNL renal puncture channel positioning, shorten the puncture time and reduce intraoperative blood loss, and provide a new method for PCNL renal puncture positioning, which is worthy of further clinical exploration.

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Multitract percutaneous nephrolithotomy in the management of staghorn stones

African Journal of Urology ◽

10.1186/s12301-020-00086-x ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Aso Omer Rashid ◽

Sarwar Noori Mahmood ◽

Aram Karim Amin ◽

Rawa Bapir ◽

Noor Buchholz

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Unit ◽

First Line ◽

Combination Treatments ◽

Stone Free Rate ◽

Staghorn Calculus ◽

Grade Ii ◽

Patient Stone ◽

Free Rate ◽

Staghorn Stones

Abstract Background Staghorn stones are difficult to manage with a risk of significant renal impairment and urosepsis. Percutaneous nephrolithotomy is the first-line treatment for staghorn stones. Often, multiple access tracts are needed to render the patient stone-free. PCNL has been combined with SWL, flexible URS (ECIRS), and mini-PCNL to access residual fragments without the need of additional tracts. However, in a country with limited access to technology and a restraint on resources, multitract PCNL still is the preferred option. The aim of this study was to assess the safety and efficacy of multitract PCNL in such an environment. Methods We analyzed data on sixty-five patients with staghorn calculus who underwent multitract PCNL for a staghorn calculus. Data included demographics, stone parameters, intraoperative parameters, complications and clinical outcomes. Hb-drop and creatinine changes were assessed pre- and post-OP. Complications were graded according to the modified Clavien-Dindo classification. Results In a total of 65 patients [47 males (72%)], 154 percutaneous access tracts were used in 66 renal units. The number of tracts varied between 2 and 4 in a single renal unit. The stone-free rate was 85%. 20% of patients developed grade I, 14% grade II, and 3% grade III b complications. There were no grade IV and V complications. Conclusion Multitract PCNL is safe and efficient, with a good stone-free rate and an acceptable complication rate. When auxiliary combination treatments are not available, multitract standard PCNL remains an option.

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