Logistic Regression Model for Predicting Stone-Free Rate After Minimally Invasive Percutaneous Nephrolithotomy

Objectives: The aim of this study was to provide a randomized controlled trial comparing the outcomes of different access sizes used in the solo ultrasonic-guided minimally invasive percutaneous nephrolithotomy (mini-PCNL). Methods: From January 2018 to December 2019, a total of 160 cases with single renal stones of <25 mm were randomized to undergo mini-PCNLs with Fr16, Fr18, Fr20, or Fr22 accesses. All accesses were established with the axis of the target calyx as the marker for puncture location and then expanded to the desired size. Hemoglobin reduction, operative time, stone-free rate, complications, etc., were all recorded and assessed. Results: The demographic data were similar, and there were no significantly intergroup differences in stone-free rate, complications, and hospital stay time. The hemoglobin reduction was comparable and was 0.9 ± 0.6, 0.9 ± 0.7, 1.0 ± 0.5, and 1.1 ± 0.7 g/dL for the groups Fr16, Fr18, Fr20, and Fr22, respectively. The operative time was 53.4 ± 14.5, 48.5 ± 15.2, 42.8 ± 13.3, and 43.3 ± 13.1 min for the 4 groups, which decreased significantly from group Fr16 to Fr20, but there was no significant difference between Fr20 and Fr22 groups. Conclusions: The axis of target calyx is a reliable marker for establishment of percutaneous renal access under ultrasonic guidance. The surgical outcomes of different access sizes were comparable, but the operation time was significantly shortened with the increase of size. However, Fr22 was not more efficient than Fr20.

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Study of the safety and efficacy of minimally invasive percutaneous nephrolithotomy in the management of large and complex renal stone

International Surgery Journal ◽

10.18203/2349-2902.isj20200812 ◽

2020 ◽

Vol 7 (3) ◽

pp. 725

Author(s):

Rushabhkumar C. Somani ◽

Chirag K. Sangada

Keyword(s):

Minimally Invasive ◽

Percutaneous Nephrolithotomy ◽

Renal Pelvis ◽

Urinary Calculi ◽

P Value ◽

Safety And Efficacy ◽

Stone Free Rate ◽

Duration Of Surgery ◽

Minimally Invasive Percutaneous Nephrolithotomy ◽

Free Rate

Background: Nephrolithiasis is highly prevalent across all demographic groups in the india and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Objective of this study to evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (PCNL) in the management of large and complex renal stone.Methods: This retrospective study includes 75 renal calculi patients with 100 renal units with large and complicated stone >20 mm. Stones were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete stag horn stones, renal pelvis stones with accompanying calyceal stones). Then various parameter like decrease haemoglobin, surgical complication, creatinine level, duration of surgery etc were compared between simple and complex stones patients by calculation p value using online student t test calculator. P value less than 0.01 considered as a difference of significance.Results: The mean stone size was 35.5±20.37 mm and mean operative duration was 60±35.3 min. In all, cases 60 (80%) were stone-free after the first procedure and another 10 needed an auxiliary procedure (5 second-look PCNL, 3 extracorporeal shockwave lithotripsy-ESWL, 2 ureterorenoscopy, and) to become stone-free, resulting in a 93.33% stone-free rate. Complications occurred in 9 procedures (12%).Conclusions: From this study, it would be concluded that Minimally invasive PCNL provided significantly higher stone-free rate and efficiency quotient for management of urinary calculi. Overall complications are usually observed in patients having intraoperative hypotension and increased intra operative time.

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94 Impact of colic pain as a significant factor for predicting the stone free rate of one-session shock wave lithotripsy for treating ureter stones: A Bayesian logistic regression model analysis

European Urology Supplements ◽

10.1016/s1569-9056(15)60096-3 ◽

2015 ◽

Vol 14 (2) ◽

pp. e94-e94a

Author(s):

D.H. Kang ◽

D.Y. Chung ◽

K.S. Cho ◽

D.H. Lee ◽

J.H. Han ◽

...

Keyword(s):

Shock Wave ◽

Logistic Regression ◽

Regression Model ◽

Shock Wave Lithotripsy ◽

Logistic Regression Model ◽

Model Analysis ◽

Stone Free Rate ◽

Ureter Stones ◽

Bayesian Logistic Regression ◽

Free Rate

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Double-Sheath Vacuum Suction Minimally Invasive Percutaneous Nephrolithotomy for Management of Large Renal Stones

Urologia Internationalis ◽

10.1159/000518259 ◽

2021 ◽

pp. 1-5

Author(s):

Zhong-Hua Wu ◽

Yong-Zhi Wang ◽

Tong-Zu Liu ◽

Xing-Huan Wang ◽

Hang Zheng ◽

...

Keyword(s):

Minimally Invasive ◽

Percutaneous Nephrolithotomy ◽

Operation Time ◽

Renal Stones ◽

Vacuum Suction ◽

Conventional Procedure ◽

Outer Sheath ◽

Stone Free Rate ◽

Minimally Invasive Percutaneous Nephrolithotomy ◽

Free Rate

Objectives: This study aimed to describe a novel double-sheath vacuum suction minimally invasive percutaneous nephrolithotomy (mini-PCNL) to overcome the deficiencies of the conventional procedure. Patients and Methods: Between March 2019 and December 2019, 65 patients (37 males and 28 females) with a mean age of 41 years (range 23–69) underwent mini-PCNL with double-sheath vacuum suction. It consisted of an F20 Y-shaped sheath as an outer sheath and an F16 Y-shaped sheath as an inner sheath, in which the inner sheath was longer than the outer sheath. The oblique arm of the outer sheath and the inner sheath was connected to the perfusion inflow and the vacuum suction, respectively. A 550-μm holmium-YAG laser was introduced for stone fragmentation through the working channel of the mini-nephroscope, which was no longer connected to the perfusion fluid. Results: All procedures were successful. Mean operation time was 50.2 min (range 39–83). Mean hemoglobin decrease was 5.2 g/L (range 1.0–15.5), and no patient needed a blood transfusion. One patient (1.5%) with low fever (<38°C) at day 1 had returned to normal at day 2 without administration of antibiotics. There were no Clavien grade 2–4 complications. Mean postoperative hospital stay was 2.4 days (range 2–6). The initial stone-free rate of PCNL was 81.53% (53 of 65 patients). One month after surgery, the final stone-free rate increased to 90.77% (59/65 patients). Conclusions: The double-sheath vacuum suction mini-PCNL is a safe and effective modality for large renal stones, which might increase the efficiency of stone extraction with low intrapelvic pressure.

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The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

BioMed Research International ◽

10.1155/2019/8619460 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Xiangjun Meng ◽

Juan Bao ◽

Qiwu Mi ◽

Shaowei Fang

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Minimally Invasive ◽

Logistic Regression Analysis ◽

Percutaneous Nephrolithotomy ◽

Operation Time ◽

Stone Size ◽

Minimally Invasive Percutaneous Nephrolithotomy ◽

Staghorn Stone

Objective. This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods. The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results. A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions. Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.

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