Laparoscopic pyelolithotomy in patients with previous ipsilateral renal stone surgery

Objectives: To evaluate the safety and efficacy of transperitoneal laparoscopic pyelolithotomy in renal stone cases with previous renal surgeries. Patients and methods: In this prospective study, 190 consecutive patients with renal stones, who were candidates for transperitoneal laparoscopic pyelolithotomy, were enrolled. The patients were divided into two groups. In group A, 163 patients without a history of renal surgery underwent standard laparoscopic pyelolithotomy, whereas in group B laparoscopic pyelolithotomy was performed in 27 patients with a history of kidney stone surgery including percutaneous nephrolithotomy or open stone surgery. All intraoperative data including the operating time and complications such as bleeding requiring transfusion were recorded. Postoperative data such as length of hospitalization, hemoglobin level alteration, and other complications were also recorded. Results: There was no significant difference in the preoperative data such as stone size, stone site, age, sex, and stone side between the two groups. There was no significant difference in the stone-free rate between the two groups (p = 0.4). There was no significant difference between the two study groups regarding the operating time, hospital stay, stone-free rate, complications, and transfusion rate. Conclusion: Laparoscopic pyelolithotomy can be used as a safe and feasible treatment modality in the setting of previous renal surgery. The complications and stone-free rate of laparoscopic pyelolithotomy in patients with history of renal surgery are acceptable.

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Factors Affecting Transfusion During Percutaneous Nephrolithotomy: A Retrospective Study of 665 Cases

10.21203/rs.3.rs-840809/v1 ◽

2021 ◽

Author(s):

Hong Zhao ◽

Jun-Sheng Li ◽

Li Li ◽

Hang Wang ◽

Yi Miao ◽

...

Keyword(s):

Blood Transfusion ◽

Percutaneous Nephrolithotomy ◽

Open Surgery ◽

Transfusion Rate ◽

Preoperative Hemoglobin ◽

Stone Burden ◽

Stone Free Rate ◽

History Of ◽

Stone Type ◽

Free Rate

Abstract Purpose: To evaluate the aspects affecting transfusion following percutaneous nephrolithotomy (PCNL).Background: From 2016 to 2019, 665 patients underwent PCNL for removal of renal calculi in our center. Complications, including hemorrhages, have been reported. Twenty-three patients (3.5%) have received a blood transfusion and twelve (1.9%) were treated by hyper-selective embolization. We focus on the influencing factors related to postoperative blood transfusion. The factors analyzed were (age, sex, hypertension, diabetes, serum creatinine level, preoperative hemoglobin, and use of anticoagulants or antiplatelet medications); renal and stone factors (previous surgery, abnormal anatomy, stone side, stone burden, stone type); and surgical features: (access number, the calyx of puncture and stone-free rate). These data were analyzed for the presence of bleeding.Results: Among individual factors, preoperative hemoglobin level (P<0.001), and urinary infection (P<0.001) were significantly correlated with blood transfusion. Among renal and stone factors, only previous history of open surgery was significantly correlated with blood transfusion (P<0.05). Stone type or stone burden does not correlate with transfusion. There was also no statistically significant correlation between surgical features and bleeding, and a lower stone-free rate reported for transfusion group.Conclusion: The obtained results demonstrated that PCNL is a safer surgery in a high volume center, but anemic conditions, infections and history of open surgery will significantly increase transfusion rate following PCNL.

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Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

F1000Research ◽

10.12688/f1000research.9509.1 ◽

2016 ◽

Vol 5 ◽

pp. 2106 ◽

Cited By ~ 1

Author(s):

Widi Atmoko ◽

Ponco Birowo ◽

Nur Rasyid

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Univariate Analysis ◽

Staghorn Calculi ◽

Stone Burden ◽

Stone Free Rate ◽

History Of ◽

Renal Stone Surgery ◽

The Mean ◽

Free Rate

Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery (p = 0.01), stone burden (p = < 0.001), and type of anesthesia (p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.

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RIRS with Vacuum-Assisted Ureteral Access Sheath versus MPCNL for the Treatment of 2-4 cm Renal Stone

BioMed Research International ◽

10.1155/2020/8052013 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Dehui Lai ◽

Yongzhong He ◽

Xun Li ◽

Meiling Chen ◽

Xingrong Zeng

Keyword(s):

Renal Stone ◽

Matched Pair ◽

Ureteral Access Sheath ◽

Access Sheath ◽

Matched Pair Analysis ◽

Pain Scores ◽

Stone Free Rate ◽

Significant Difference ◽

Matching Criteria ◽

Free Rate

Objective. Comparison of outcomes between RIRS with vacuum-assisted ureteral access sheath (V-UAS) and MPCNL in the treatment of renal stone. Materials and Methods. 28 patients with 2-4 cm renal stone were treated using RIRS with 14/16 F V-UAS. The outcomes were compared to those who underwent MPCNL with 16 F Amplatz sheath using a matched-pair analysis in a 1 : 2 scenario. Matching criteria included stone size, location and laterality, gender, age, BMI, and degree of hydronephrosis. Patients’ demographics, perioperative and postoperative characteristics, complications, stone-free rate (SFR), and auxiliary procedures were compared. Results. Mean operative times for the RIRS and MPCNL groups were 72.4±21.3 minutes and 67.4±25 minutes (P=0.042). Postoperative pain was significantly less in the RIRS group. The initial SFR was 50% for the RIRS group and 73.2% for the MPCNL group (P=0.035). The final SFR at postoperative three months improved to 89.3% for the RIRS group and 92.9% for the MPCNL group (P=0.681). The auxiliary procedure rates were higher in the RIRS group (42.9% vs. 25%, P=0.095). The overall complication rate in the RIRS group was lower, but the significant difference was not found. Conclusion. In the treatment of 2-4 cm renal stone, using V-UAS in RIRS can improve surgical efficiency with lower postoperative early pain scores. Comparing with MPCNL, its initial SFR was more depressed, and there is still a trend towards requiring more auxiliary procedures to achieve comparable final SFR.

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Safety and Efficacy of Percutaneous Nephrolithotomy in Children

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v15i2.18192 ◽

2017 ◽

Vol 15 (2) ◽

pp. 130-134 ◽

Cited By ~ 2

Author(s):

Udaya Man Singh Dongol ◽

Yugal Limbu

Keyword(s):

Blood Transfusion ◽

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Anatomical Location ◽

Transfusion Rate ◽

Safety And Efficacy ◽

Stone Free Rate ◽

The Mean ◽

Tract Infections ◽

Free Rate

Background: Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.Methods: Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.Results: The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.Conclusions: Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.

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Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

F1000Research ◽

10.12688/f1000research.9509.2 ◽

2016 ◽

Vol 5 ◽

pp. 2106 ◽

Cited By ~ 1

Author(s):

Widi Atmoko ◽

Ponco Birowo ◽

Nur Rasyid

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Univariate Analysis ◽

Staghorn Calculi ◽

Stone Burden ◽

Stone Free Rate ◽

History Of ◽

Renal Stone Surgery ◽

The Mean ◽

Free Rate

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Amplatz versus Balloon for Tract Dilation in Ultrasonographically Guided Percutaneous Nephrolithotomy: A Randomized Clinical Trial

BioMed Research International ◽

10.1155/2019/3428123 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Hamid Pakmanesh ◽

Azar Daneshpajooh ◽

Mahboubeh Mirzaei ◽

Armita Shahesmaeili ◽

Morteza Hashemian ◽

...

Keyword(s):

Operating Time ◽

Balloon Dilation ◽

Study Groups ◽

Single Step ◽

Transfusion Rate ◽

Lower Pole ◽

Stone Free Rate ◽

Duration Of Hospitalization ◽

Tract Dilation ◽

Mean Cost

Purpose. To compare balloon with Amplatz for tract dilation in totally ultrasonographically guided PCNL (UPCN). Methods. We randomized 66 patients candidate for sonographically guided PCNL in the flank position in two study groups. In the first group, we used single step Amplatz dilation (AG) technique in which the 28- or 30-French Amplatz dilator is used for tract dilation. In the other group, we dilated the tract using balloon dilator (BG). We compared procedure time, success rate of dilation, and postoperative clinical outcomes and cost between two groups. Results. The rate of short dilation was higher in the Amplatz group (57.6%) compared with Balloon group (36.4%) (P=0.08). When using Amplatz for lower pole access, short dilation occurred in 81% of cases compared with 44% in the BG (P=0.02). Overall operation was longer in the AG (80±21 versus 65±20 minutes P=0.02). Stone free rate was 87.9% in the AG compared with 72.7% in the BG (p=0.12). Mean cost of the surgery was 603±85 USD and 718±78 USD in the AG and BG, respectively (P=0.0001). Hemoglobin drop, transfusion rate, renal function alteration, duration of hospitalization, and complication rate based on Clavien classification were similar in both groups. Conclusions. AG showed a higher rate of short dilation compared with BG; consequently, overall operating time was significantly longer in the AG whereas BG was significantly more expensive than AG. Bleeding and other complications were similar in two groups. We observed an advantage for balloon dilation over Amplatz when approaching the lower pole calyxes.

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EVALUATING FACTORS RELATED TO THE RESULT OF OPEN OPERATION ON COMPLEX RENAL STONE TREATMENT WITH MULTIPLE STONES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.35 ◽

2017 ◽

pp. 215-251

Author(s):

The Huynh Nguyen ◽

Dinh khanh Le

Keyword(s):

Urinary Tract ◽

Kidney Stones ◽

Renal Stone ◽

Gender History ◽

Female Ratio ◽

Surgical Result ◽

Open Operation ◽

Stone Free Rate ◽

History Of ◽

Free Rate

Objective: To evaluate factors related to stone - free rate of open operation for treatment of multiple/ staghorn kidney stones. Materials and Methods: Prospective study comprises of 56 patients with multiple/ staghorn kidney stones underwent open surgery at Hue Central Hospital and Hue University Hospital from April 2016 to June 2017. We evaluate the relationship between age, gender, surgical history, hydronephrosis, location of stones, size of stones, number of stones, renal pelvic aspect and stone – free rate after surgery. Results: Male/female ratio is 35/21 (62.5%/27.5%). The average age is 52.3 ± 15.3, (the youngest age is 12, the highest is 76). The stone – free rate is 62.5%, the rate of stone residue is 37.5%. The factors related to surgical result are gender, history of urinary tract surgery, hydronephrosis, location and size of stones, number of stones, renal pelvic aspect and methode (pyelotomy/nephrostomy) for removing stones. There is no relation between age of the patient and result of operation. Conclusion: The factors related to surgical result are gender, history of urinary tract surgery, hydronephrosis, location and size of stones, number of stones, renal pelvic aspect and methode (pyelotomy/nephrostomy) for removing stones. There is no relation between age of the patient and result of operation. Key words: Renal stone, multiple/staghorn kidney stones

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COMPARISON OF PERCUTANEOUS NEPHROLITOTOMY (PCNL) IN PRONE AND SUPINE POSITION: A SINGLE CENTRE EXPERIENCE REPORT

Indonesian Journal of Urology ◽

10.32421/juri.v28i1.643 ◽

2021 ◽

Vol 28 (1) ◽

pp. 39-43

Author(s):

Ferry Safriadi ◽

Dadan Ramdhan

Keyword(s):

Hospital Stay ◽

Prone Position ◽

Percutaneous Nephrolithotomy ◽

Supine Position ◽

Operating Time ◽

Transfusion Rate ◽

Major Complications ◽

Stone Free Rate ◽

The Mean ◽

Free Rate

Objective: This study aims to compare outcomes of supine percutaneous nephrolithotomy to prone percutaneous nephrolithotomy as a traditional approach in Hasan Sadikin Hospital Bandung. Material & Methods: Data was taken from urology’s database between 2003-2012, which contain data of prone position (2003-2007), and supine position (2008-2012). Three hundred forty-nine patients were included in this study. We reviewed data on demography, stone burden, operating time, stone-free rate, transfusion rate, hospital stay, and major complications. Results: Of 174 patients underwent prone position, and 175 patients were part of the supine position. Age means of prone position was 51.0 years old, the supine position was 50.5 years old. The number of male patients was 65.5% for prone, and 66.1% for supine. The mean stone's largest diameter of prone was 23.87 mm, supine was 22.36 mm. The operating time of prone was 107 minutes; supine was 90 minutes. The stone-free rate of prone was 94.7%; supine was 91.3%. The mean hospital stays of prone was 14.3 days; supine was 9.6 days. The transfusion rate of prone position was 8.9%, supine was 7.2%. No major complications were recorded. Conclusion: Higher stone-free rates are achieved with patients in the prone position during PCNL. Supine position has shorter operating time, and hospital stay, lower blood transfusion rates. The complication rate is not different between the two positions.

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Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones

Canadian Urological Association Journal ◽

10.5489/cuaj.490 ◽

2013 ◽

Vol 7 (3-4) ◽

pp. E171-175 ◽

Cited By ~ 11

Author(s):

Yasser M. Haggag ◽

Gamal A. Morsy ◽

Magdy M. Badr ◽

Abdel Baset A. Al Emam ◽

Mourad M. Mourad ◽

...

Keyword(s):

Percutaneous Nephrolithotomy ◽

University Hospitals ◽

Patient Demographics ◽

Laparoscopic Pyelolithotomy ◽

Postoperative Blood Transfusion ◽

Estimated Blood Loss ◽

Stone Free Rate ◽

Significant Difference ◽

Group 2 ◽

Free Rate

Background: The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL).Methods: This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm2 or greater were included. Group1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed.Results: There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 ± 12.25 [range: 52.75- 77.25] vs. 180 ± 20.74 [range: 159.26- 200.74] mL, p ≤ 0001), mean hospital stay (2.3 ±0.64 [range: 1.66- 2.94] vs. 3.7 ± 1.4 [range: 2.3- 5.1] days, p ≤ 0.006), rate of postoperative blood transfusion (0% vs. 4.8%,p ≤ 0.0024), and stone-free rate (80% vs. 78.6%, p ≤ 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 ± 22.11 [range: 108.89-153.11) vs. 51.19 ± 24.39 [range: 26.8-75.58] min, p ≤ 0001), respectively.Conclusion: Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones.

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One Shot Dilatation (OSD) in Percutaneous Nephrolithotomy (PCNL) - A Safe and Feasible Technique

Bangladesh Journal of Urology ◽

10.3329/bju.v23i2.50300 ◽

2020 ◽

Vol 23 (2) ◽

pp. 114-117

Author(s):

Abdul Matin Anamur Rashid Choudhury ◽

Tohid Mohammad Saiful Hossain ◽

Tasmina Parveen

Keyword(s):

Radiation Exposure ◽

Percutaneous Nephrolithotomy ◽

Operating Time ◽

Fluoroscopy Time ◽

Access Time ◽

Control Group ◽

Transfusion Rate ◽

Stone Free Rate ◽

Tract Dilation ◽

Free Rate

Objective: To evaluate the feasibility, safety and efficacy of one-shot dilation (OSD) in standard percutaneous nephrolithotomy (PCNL). Methods: This is a prospective, single -center study conducted between January 2017 to June 2019. Patients who underwent PCNL using one shot dilatation (21 – 24 Fr) for access in PCNL were included in the study. Access time, fluoroscopy time, successful dilation time, stone free rate, decrease hemoglobin level and transfusion rate, complication rate, length of post operative hospital stay, cost were recorded. Data was analyzed and reported using summary statistics. Results: A total of 30 patients were enrolled in this survey. 30 patients in one shot dilation (OSD) group.The mean age was 39.5 years. Control group of 30 patients were included in standard PCNL procedure where method of tract dilation was done by regid Amplatz dilators. Access time and fluoroscopy time in OSD group was approximately shorter. Statistically it was significant. Successful dilation and stone free rate were subsequently 98% and was significant. Data collected included patient access time, radiation exposure, total operating time, preoperative and postoperative hemoglobin concentrations, tract dilatation failures, complications and transfusions. Conclusion: The use of one shot and standard prone position under general anaesthesia combines the advantages of these both methods including less radiation exposure and shorter access and operative time. One shot dilation technique is safe, economical and feasible technique with added advantage,lesser radiation exposure and lesser chance of blood transfusion. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.114-117

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