MP30-05 A PROSPECTIVE EVALUATION OF THE SURGEON PERSPECTIVE FOR DETERMINING STONE-FREE STATUS AFTER PERCUTANEOUS NEPHROLITHOTOMY

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Ahmed Harraz ◽  
Yasser Osman ◽  
Osama Mahmoud ◽  
Amr Elsawy ◽  
Islam Fakhreldin ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Prospective Evaluation ◽  
Free Status

692 A prospective evaluation of the surgeon perspective in determining stone-free status after percutaneous nephrolithotomy

2015 ◽  
Vol 14 (2) ◽  
pp. e692
Author(s):  
O. Mahmoud ◽  
A.M. Harraz ◽  
Y. Osman ◽  
A.A. El-Sawy ◽  
I. Fakhreldin ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Prospective Evaluation ◽  
Free Status

scholarly journals Cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy, a randomized controlled trial (CAPTURE) protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. A. Kingma ◽  
I. J. de Jong ◽  
M. J. W. Greuter ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Randomized Controlled Trial ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
Controlled Trial ◽  
Cone Beam ◽  
Total Study Population ◽  
Randomized Controlled ◽  
Free Status

Abstract Introduction Percutaneous nephrolithotomy (PCNL) is the standard surgical treatment method for large kidney stones. Its aim is to achieve a stone-free status, since any residual fragments (RFs) after PCNL are likely to cause additional morbidity or stone growth. Enhancing intraoperative detectability of RFs could lead to increased stone-free rates and decreased re-intervention rates. Cone beam computed tomography (CBCT) has recently been introduced in urology as a feasible method for intraoperatively imaging RFs. The aim of this trial is to determine the added value of CBCT in percutaneous nephrolithotomy, by measuring differences in stone-related morbidity for patients with procedures in which a CBCT is used versus patients with procedures without the use of CBCT. Methods The CAPTURE trial is an investigator-initiated single-center, randomized controlled trial (RCT) in adult patients who have an indication for percutaneous nephrolithotomy. A contemporary percutaneous nephrolithotomy is performed. Once the surgeon is convinced of a stone-free status by means of fluoroscopy and nephroscopy, randomization allocates patients to either the study group in whom an intraoperative CBCT scan is performed or to the control group in whom no intraoperative CBCT scan is performed. The main endpoint is the stone-free status as assessed four weeks postoperatively by low-dose non-contrast abdominal CT, as a standard follow-up procedure. Secondary endpoints include the number of PCNL procedures required and the number of stone-related events (SREs) registered. The total study population will consist of 320 patients that undergo PCNL and are eligible for randomization for an intraoperative CBCT scan. Discussion We deem a randomized controlled trial to be the most effective and reliable method to assess the efficacy of CBCT in PCNL. Though some bias may occur due to the impossibility of blinding the urologist at randomization, we estimate that the pragmatic nature of the study, standardized circumstances, and follow-up methods with pre-defined outcome measures will result in a high level of evidence. Trial registration Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Registered on 15 October 2019. Prospectively registered.

scholarly journals Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052091125
Author(s):  
Chunxiao Wei ◽  
Tengteng Wang ◽  
Shaoan Chen ◽  
Xiangbin Ren ◽  
Xiude Chen
Keyword(s):  
Renal Function ◽  
Success Rate ◽  
Percutaneous Nephrolithotomy ◽  
Ureteropelvic Junction Obstruction ◽  
Balloon Dilation ◽  
Renal Calculi ◽  
Ureteropelvic Junction ◽  
High Grade ◽  
Free Status ◽  
Grade Iii

Objective This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous nephrolithotomy (PCNL) and antegrade balloon dilation. Methods We retrospectively reviewed 31 patients who underwent PCNL and antegrade balloon dilation for treatment of renal calculi and recurrent UPJO. The inclusion criterion was the presence of UPJO after failed pyeloplasty with ipsilateral renal calculi. Success was defined as achievement of both symptomatic and radiographic resolution of any stones and obstruction. Results All operations were successful without grade III or higher postoperative complications. A stone-free status was observed in all patients and the overall success rate of the procedure was 87.1% (27/31). The success rate of the procedure was significantly higher in patients with mild or moderate preoperative hydronephrosis (96%) than in those with high-grade preoperative hydronephrosis (50%). Moreover, the success rate of the procedure was lower in patients with poor preoperative renal function (0%) than in those with good or moderate renal function (93.1%). Conclusion Combined PCNL and antegrade balloon dilation management represents a safe and effective approach for patients with renal calculi and recurrent UPJO after failed pyeloplasty.

Percutaneous nephrolithotomy of staghorn renal stones in pediatric patients using adult-sized instrument

2019 ◽  
Vol 86 (4) ◽  
pp. 211-215
Author(s):  
Akbar Nouralizadeh ◽  
Hamid Pakmanesh ◽  
Abbas Basiri ◽  
Mohammad Hadi Radfar ◽  
Behzad Narouie ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Pediatric Patients ◽  
Renal Stones ◽  
Adult Size ◽  
Efficacy And Safety ◽  
Double J Stent ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate ◽  
Free Status

Introduction: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone. Methods: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter. Results: The mean age was 108 ± 53 months (range, 14–180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred. Conclusion: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.

Prospective evaluation of safety and efficacy of the supracostal approach for percutaneous nephrolithotomy

2002 ◽  
Vol 90 (9) ◽  
pp. 809-813 ◽  
Author(s):  
R. Gupta ◽  
A. Kumar ◽  
R. Kapoor ◽  
A. Srivastava ◽  
A. Mandhani
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Prospective Evaluation ◽  
Safety And Efficacy

scholarly journals Comparison of STONE score with Guy’s stone score as a tool to predict stone clearance rates in patients undergoing percutaneous nephrolithotomy: a single center study

2020 ◽  
Vol 8 (1) ◽  
pp. 339
Author(s):  
Anoop Handa ◽  
Sharat Chandra Dash ◽  
Nimit Solanki ◽  
Abhishek Shukla ◽  
Gagandeep Singh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Predictive Accuracy ◽  
Operating Time ◽  
Scoring Systems ◽  
Single Center Study ◽  
Stone Free Rate ◽  
The Mean ◽  
The Relationship ◽  
Free Status

Background: We aimed to compare the Guy’s stone score and STONE nephrolithometry score and assess their predictive accuracy for percutaneous nephrolithotomy (PCNL) outcomes.  Methods: A total of 100 patients, who underwent PCNL between Jan 2018 and Dec 2018 were included in the study. All patients were evaluated with computerized tomography (CT) scan preoperatively and scores were calculated. Patient demographic characteristics, intraoperative and postoperative variable were evaluated. The relationship between the Guy’s and STONE scores, and their prediction for postoperative stone-free status, complications were compared. Results: The mean Guy’s score was 2.04±1.01, and the mean STONE score was 8.0+1.7. The mean operative time was 101.9+41 minutes and the mean blood loss was 170+113ml. The complication rate in our study was found to be 32%, majority were grade 1-2. Both scoring systems showed positive correlation with stone burden, operating time and blood loss. The overall stone free rate was 72% and both the GSS and STONE score were significantly associated with success of the procedure.  Conclusions: Both Guy’s and STONE scoring systems are equally effective in predicting stone-free status.  

Prospective Evaluation of Learning Curve of Urology Residents for Percutaneous Nephrolithotomy

2016 ◽  
Vol 3 (3) ◽  
pp. 230-235 ◽  
Author(s):  
Amit Garg ◽  
Sher S. Yadav ◽  
Vinay Tomar ◽  
Shivam Priyadarshi ◽  
Vikas Giri ◽  
...  
Keyword(s):  
Learning Curve ◽  
Percutaneous Nephrolithotomy ◽  
Prospective Evaluation ◽  
Evaluation Of Learning

Stone Localization Is Pivotal for the Success of Percutaneous Nephrolithotomy

2021 ◽  
pp. 1-7
Author(s):  
Tammo Lesch ◽  
Jens Uphoff ◽  
Wolfgang Mayer ◽  
Alexander Winter ◽  
Friedhelm Wawroschek ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Percutaneous Nephrolithotomy ◽  
Treatment Success ◽  
Regression Analyses ◽  
Multivariable Logistic Regression ◽  
Controlled Treatment ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Impact On Treatment ◽  
Free Status ◽  
Residual Stones

<b><i>Objective:</i></b> The objective of this study was to predict computed tomography (CT)-controlled treatment success after minimally invasive percutaneous nephrolithotomy (Mini-PCNL). <b><i>Patients and Methods:</i></b> We relied on retrospective single institutional data from 92 kidney stone patients treated with Mini-PCNL. Residual stones after treatment were evaluated by post-Mini-PCNL CT scans. Stone-free status was defined as clinically insignificant residual stones ≤3 mm after surgery. Multivariable logistic regression analyses predicted stone-free status after Mini-PCNL. <b><i>Results:</i></b> Overall, 53 (57.6%) patients achieved stone-free status after Mini-PCNL treatment. In multivariable logistic regression analyses, stone localization was the strongest predictor for stone-free status after Mini-PCNL. Specifically, patients with exclusively pelvic stones were 7.1-fold more likely to achieve stone-free status than those patients with stones at multiple localizations (OR: 7.1; <i>p</i> = 0.005). Additionally, stone size represented a barrier for stone-free status (OR: 0.9; <i>p</i> = 0.03). <b><i>Conclusions:</i></b> Stone localization revealed the highest impact on treatment success after Mini-PCNL. Especially, those patients with exclusively pelvic stones were most likely to achieve stone-free status. Conversely, patients with multiple stone localizations were less likely to achieve stone-free status and need to be informed about higher risk of additional interventions after initial Mini-PCNL.

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