Doppler Ultrasound and X-Ray-Guided Percutaneous Nephrolithotomy with One-Step Balloon Dilation for Complex Renal Stones

The complications of percutaneous nephrolithotomy (PNL) include hemorrhage, damage to adjuvant organs, and other medical issues, although intracardiac migration of ureteral double-J stent has never been found during PNL and delaying the diagnosis might cause mortality. We report the case of a 60-year-old male who was admitted to receive one-stage PNL for right renal stones. During operation, an unexpected atrial fibrillation with a drop in blood pressure was suddenly encountered and the chest X-ray subsequently showed that the ureteral double-J had penetrated deep into the heart. Emergent endovascular intervention was performed to remove the stent and the patient was uneventfully discharged 2 days later.

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Re: Xu Y: Doppler Ultrasound-guided Percutaneous Nephrolithotomy With Two-step Tract Dilation for Management of Complex Renal Stones (Urology February 24, 2012 [Epub ahead of print])

Urology ◽

10.1016/j.urology.2012.03.017 ◽

2012 ◽

Vol 80 (3) ◽

pp. 745-746

Author(s):

Abdulkadir Tepeler ◽

Tolga Akman ◽

Cevper Ersoz ◽

Abdullah Armagan

Keyword(s):

Doppler Ultrasound ◽

Percutaneous Nephrolithotomy ◽

Renal Stones ◽

Ultrasound Guided ◽

Tract Dilation

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Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

Advances in Urology ◽

10.1155/2014/423730 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Abdul Rouf Khawaja ◽

Tanveer Iqbal Dar ◽

Ajay Kumar Sharma ◽

Farzana Bashir ◽

Vipin Kumar Tyagi ◽

...

Keyword(s):

Prospective Study ◽

Percutaneous Nephrolithotomy ◽

Renal Stones ◽

Single Center ◽

Stone Clearance ◽

X Ray ◽

Routine Investigation ◽

Single Center Experience ◽

Second Look ◽

A Prospective Study

Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN) is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients.Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients.Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram.Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

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Percutaneous nephrolithotomy through superior calyceal approach - our experience

Pulse ◽

10.3329/pulse.v3i1.6543 ◽

1970 ◽

Vol 3 (1) ◽

pp. 4-6

Author(s):

AU Shaikh ◽

R Biswas ◽

NUM Arif ◽

N Miah ◽

W Zaman

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Invasive Procedure ◽

Renal Stones ◽

Renal Calculi ◽

Stone Size ◽

Stone Clearance ◽

X Ray ◽

Percutaneous Punctures ◽

Main Complication

Introduction: Percutaneous Nephrolithotomy (PCNL) is considered the treatment of choice for large (> 2 cm size) renal stones at present. Aim of this study was to evaluate the results of PCNL as monotherapy in our centre which were done through superior calyceal approach.Materials and Methods: Seventy five patients with three bilateral renal stone (total 78 renal units) that underwent PCNL through superior calyceal approach at Apollo Hospitals Dhaka from May 15, 2005 to December 15, 2007 were included in this retrospective study. Selected patients had renal stones more than 2 cm in size (average stone size 35 mm and surface area 750 mm2). Ultrasonogram, intravenous urogram and in some selected cases CT scan were done to detect the location and size of the stone. Urologist performed percutaneous punctures through superior calyx in prone position under fluoroscopic guidance and general anaesthesia were employed in all cases. Post-operative stone clearance was documented on plain X-ray KUB and ultrasonogram KUB.Results: PCNL was successfully (complete stone clearance and insignificant residue) carried out in 68 patients (69 renal units). Average stone clearance was 88.46%. No second look procedures were needed. Uro-sepsis was the main complication, occurred in 9 renal units (11.53 %) while urinary leakage/ fistula in 6.41%, significant bleeding in 6 renal units (7.69 %) and pleural breach with fluid in pleural cavity (hydrothorax) in 2 (2.6 %) cases. Mean blood transfusion was 1.2 units and mean hospital stay was 67 hours.Conclusion: Monotherapy with PCNL is highly effective in the treatment of large volume renal calculi and staghorn calculi using superior calyceal supracostal and subcostal approach. As a minimally invasive procedure, it is quite safe in experienced hand.Keywords: Percutaneous nephrolithotomy, Renal stone, Superior calyceal puncture, Staghorn calculiDOI: 10.3329/pulse.v3i1.6543Pulse Vol.3(1) July 2009 p4-6

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