scholarly journals Intraoperative flexible nephroscopy during percutaneous nephrolithotomy: An 8 years’ experience

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Yasir Masood ◽  
Nadeem Iqbal ◽  
Raja Mohsin Farooq ◽  
Sajid Iqbal ◽  
Faheemullah Khan
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Hounsfield Unit ◽  
Renal Stones ◽  
Stone Size ◽  
Group I ◽  
Stone Free Rate ◽  
Group Ii ◽  
Free Rate

Objectives: To see the effect of intra operative antegrade flexible nephroscopy during Percutaneous nephrolithotomy on stone free rate. Methods: We retrospectively reviewed electronic medical records of patients who underwent percutaneous nephrolithotomy from 2010 to 2017 for renal stones >2cm. Patients found eligible were divided in, Group-I who did not have intraoperative Flexible nephroscopy and Group-II who had flexible nephroscopy during percutaneous nephrolithotomy. All procedures were done by senior consultants. Variables like Mean age, side, stone size, skin to stone distance and Hounsfield unit were compared. Outcomes like Stone free rate, hospital stay and operative time were compared between the groups. Results: The study included 248 patients, consisting 85 (34.3%) females and 163 (65.7%) males. Mean age ± SD was 45.8±13.8 years. Both group were similar in characteristics like mean age, stone size, skin to stone distance and Hounsfield units. The overall stone free rate was 71%. It was not significantly different between the groups, 76% in Group-II vs. 67% in Group-I. However stone free rate markedly improved with flexible nephroscopy in patients with staghorn calculi. Mean operative time and hospital stay were similar between the groups. Conclusions: Intraoperative flexible nephroscopy during percutaneous nephrolithotomy significantly increases stone free rate in patients with staghorn stones. doi: https://doi.org/10.12669/pjms.37.3.3565 How to cite this:Masood Y, Iqbal N, Farooq RM, Iqbal S, Khan F. Intraoperative flexible nephroscopy during percutaneous nephrolithotomy: An 8 years’ experience. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3565 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Percutaneous nephrolithotomy versus open surgery for treatment of staghorn stones in pediatric patients

2014 ◽  
Vol 8 (11-12) ◽  
pp. 906 ◽  
Author(s):  
Ahmed R. EL-Nahas ◽  
Ahmed A Shokeir ◽  
Ahmed M Shoma ◽  
Ibrahim Eraky ◽  
Osama M Sarhan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Open Surgery ◽  
Renal Stones ◽  
Small Sample ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Group 2 ◽  
Free Rate ◽  
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. 

scholarly journals Outcomes of Open Cystolithotomy and Percutaneous Cystolithotripsy in the Management of Urinary Bladder Stone

2022 ◽  
Vol 19 (1) ◽  
pp. 1-4
Author(s):  
Naresh Man Shrestha
Keyword(s):  
Urinary Bladder ◽  
Hospital Stay ◽  
Operation Time ◽  
Bladder Stone ◽  
Medical College ◽  
Group I ◽  
Stone Free Rate ◽  
Urinary Tract Stone ◽  
Group Ii ◽  
Free Rate

Introduction: Urinary bladder stone occupies only 5% of all urinary tract stone. Various techniques have been used for the management of bladder stone. Open Cystolithotomy is the traditional treatment but a percutaneous approach has been also in practice. Aims: To confirm the best options between open cystolithotomy and percutaneous cystolithotripsy for the treatment of bladder stone. Methods: It is a prospective hospital based study from May 2019 to January 2021 in Nepalgunj Medical College. Total 42 patients with inclusion criteria were divided into two groups.  Group I was allocated to 21 patients who were treated with open cystolithotomy while Group II were allocated to 21 patients who were treated with percutaneous cystolithotripsy. Two groups were compared for stone free rate, mean hospital stay, mean postoperative scar, mean operation time and rate of post-operative complications. Results: The stone free rate in Group I was 100 % and in Group II was 90.47 %. Mean Operation time was in Group I and Group II were 40.09+ 2.48  minutes and 31.38+15.65 days,  respectively with p<0.05. Mean hospital stay was significantly low in Group II (3.71+1.87 days ) when compared to Group I (7.67+ 2.12 days) with p<0.001. Mean scar length of Group I (5.466+2.9 cm) with respect to Group II (1.04+0.09) was significantly long (p<0.01). Rate of complications were not significantly different between two groups (p>0.5). Conclusion: For management of urinary bladder stones sized up to 4 cm, both open cystolithotomy and percutaneous cystolithotripsy are effective, with a low incidence of complications. However, comparing the surgery time, hospital stay, length of scar between two procedures, percutaneous cystolithotripsy procedure is more beneficial for treatment of urinary bladder stone.

scholarly journals The Safety and Efficacy of Mini Percutaneous Nephrolithotomy During Learning Curve

2019 ◽  
Vol 18 (2) ◽  
pp. 42-47
Author(s):  
Bikash Bikram Thapa ◽  
Bina Basnet ◽  
Bikash Bahadur Rayamajhi ◽  
Narayan Thapa ◽  
Bharat Bhadur Bhandari
Keyword(s):  
Learning Curve ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Medium Size ◽  
Stone Size ◽  
Access Sheath ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Introduction: Since its introduction in 1976, percutaneous renal stone surgery has undergone several modifications. Reduction in size of access sheath was one of them which was first reported by Jackman in 1998. The miniaturisation of access sheath in Mini-Percutaneous Nephrolithotomy surgery has significantly reduced the intervention related morbidity with similar outcome as of standard Percutaneous Nephrolithotomy. Methods: This is a prospective cohort study where a single surgeon without previous experience of independent PCNL surgery performed Mini PCNL under controlled condition for renal stone sized 10 to 30 mm. The outcome was measured in terms of stone free rate and postoperative complications. The association of stone free rate and drop in haemoglobin level with different preoperative and operative variables were calculated with Pearson’s correlation test and p value <0.05 was considered significant. Results: Mini PCNL was performed in total of 63 renal units. The mean age was 37.8 ± 9.9 years with male: female ratio of 1.8:1. The average stone size was 16.8 ± 2.9 mm. The mean operative time was 55.2 ± 19.0 (30-110) minutes. The stone free rate was 98.2 ± 3.6 %. The mean drop in haemoglobin was 1.3 ± 0.8 and blood transfusion rate was 4.7%. The average hospital stay was 2.6 ± 1.3 days. The grade I complications was 15.8% and grade II and III was 7.9% each. Stone free rate was significantly associated with stone number (r = -0.47, p = 0.004). Similarly fall in haemoglobin was associated with total operative time (r = 0.49, p = 0.003). The stone size, hardness of stone (HU) and size of access sheath had no significant association with stone free rate and fall in haemoglobin. Conclusions: Mini PCNL is as effective as standard PCNL with higher safety margin in small and medium size stone (10 to 30 mm) during learning curve of endo-urology procedure.  

scholarly journals Mini-percutaneous nephrolithotomy in surgery of nephrolithiasis

2021 ◽  
pp. 44-52
Author(s):  
Аndriy Sahalevych ◽  
Roman Sergiychuk ◽  
Vladislav Ozhohin ◽  
Olexandr Vozianov ◽  
Andriy Khrapchuk ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Renal Calculi ◽  
Stone Free Rate ◽  
Duration Of Surgery ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Tract Infections ◽  
Free Rate

Abstract. The present study aimed to assess the effectiveness and safety of mini-percutaneous nephrolithotomy (mPNL) in comparison with standard percutaneous nephrolithotomy (sPNL) for the treatment of complex nephrolithiasis. Methods. During the period from 2012 to 2020, 1021 patients with solitary (10.0-30.0 mm), staghorn and multiple renal calculi were retrospectively divided into two groups: sPNL (500 patients) and mPNL (521 patients). The groups were compared by the stone-free rate (%, SFR), the duration of the surgery, complications and hospital stay. Results. SPNL and mPNL were highly effective procedures for the treatment of nephrolithiasis. The mPNL group had longer operative times (81.0±15.5 vs 69.1±13.9 min, p<0.001) and higher frequency tubeless/totally tubeless procedures (41.1 vs 6.8%, p<0.001). mPNL showed a higher SFR (96.4 vs 91.8%, р=0.002 in patients with complete staghorn (90.1 vs 77.3%, p<0.05) and multiple kidney stones (89.5 vs 70.8%, p=0.03). Postoperative decrease in hemoglobin was lower in mPNL group 1.1±0.34 vs 2.1±0.26 g/dl (p<0.001). The incidence rate of urinary tract infections and postoperative hospital stay was lower in the mPNL group: 7.3 vs 13.2%, p=0.03 and 1.9±0.6 vs 4.3±2.4 days, р<0.001. Conclusions. MPNL is a safe and effective treatment for patients with complex renal stones with an improved stone-free rate and lower complication rate and shorter hospital stay. Smaller diameter tract in mPNL procedures was associated with a longer duration of surgery.

A Comparative Study of Percutaneous Nephrolithotripsy and Extracoeporeal Shockwave Lithotripsy For The Treatment of Lower Pole Kidney Stone of Size 10-20 mm

2021 ◽  
Vol 18 (2) ◽  
pp. 39-43
Author(s):  
Naresh Man Shrestha
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Shockwave Lithotripsy ◽  
Lower Pole ◽  
Group I ◽  
Lower Pole Stone ◽  
Stone Free Rate ◽  
Group Ii ◽  
Percutaneous Nephrolithotripsy ◽  
Free Rate

Introduction: A renal stone is commonly found at the Lower-pole of the kidney.  Studies have reported various opinions about efficacy and safety of Percutaneous Nephrolithotripsy  and Extracoeporeal Shockwave Lithotripsy  for the treatment of lower pole stone  of size 10-20 mm.  Aims: The present study aimed to compare between Percutaneous Nephrolithotripsy and Extracoeporeal Shockwave Lithotripsy for safe and effective treatment of lower pole stone of size 10-20 mm. Methods: It is a prospective study conducted from December 2019 to November 2020 in the Urology Department of Nepalgunj Medical College. Total 66 patients under inclusion criteria were divided into two groups. Group I (32 patients) was allocated for patients who were treated under Percutaneous Nephrolithotripsy while Group II (34 patients) was allocated for patients who were treated with Extracoeporeal Shockwave Lithotripsy. Two groups were compared for stone free rate, retreatment rate, auxiliary treatment (%), operation time, hospital stay, haematuria, blood transfusion, obstruction and fever. Results: The stone free rate was significantly higher in  Group I when compared to Group II. While the rate of retreatment and auxiliary treatment were significantly lower in Group I than Group II. However, mean hospital stay, mean operation time and the rate of haematuria was significantly higher in Group I when compared to group II. There were no statistically significant differences between Group I and Group II for post-operative complications such as, blood transfusion, obstruction and fever. Conclusion: Stone free rate was significantly higher in Group I while retreatment rate and auxiliary treatment rate were significantly higher in Group II. Therefore, Percutaneous Nephrolithotripsy is more effective for the treatment of the lower pole stone of size 10-20mm when compared to Extracoeporeal Shockwave Lithotripsy.  However, duration of hospital stay and operation time were longer and incidence of haematuria was higher in Percutaneous Nephrolithotripsy than Extracoeporeal Shockwave Lithotripsy.

scholarly journals Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ali Akkoç ◽  
Cemil Aydın ◽  
Murat Uçar ◽  
Murat Topçuoğlu
Keyword(s):  
Body Mass Index ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Stone Size ◽  
Postoperative Fever ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Retrospective Comparative Study

Objective: Bleeding is one of the most common and alarming complication of percutaneous nephrolithotomy (PCNL). In this study, we aimed to compare the effects of ciprofloxacin and cefuroxime on the bleeding in PCNL procedures. Methods: The study was a retrospective analysis of 97 patients who underwent PCNL between February 2011 and June 2017. We just included the patients who had single tract lower pole PCNL for more objective evaluation of bleeding in the study. The patients were divided into two groups as ciprofloxacin group (Group-I, n:40) and cefuroxime group (Group-II, n:56) according to the type of antibiotic used in the operation. Patient age, gender, body mass index, stone size, preoperative INR, preoperative and postoperative platelet counts and difference, operative time, need for blood transfusion, postoperative fever, hospital stay, postoperative hemoglobin and hematocrit drop were analyzed. Results: There was no statistically significant difference in patients’ gender distribution, body mass index, preoperative INR, preoperative and postoperative platelet counts, preoperative and postoperative platelet difference, duration of operation, hospital stay, postoperative fever and need for postoperative blood transfusion between two antibiotic groups (p > 0.05). Mean patient age was 42,75±16,97 in Group-I and 35,54±14,71 in Group-II (p < 0.05). The mean stone size of Group-I and Group-II were 27,23±7,05 mm and 30,59±8,20, respectively (p < 0.05). The mean postoperative hemoglobin and hematocrit drop were significantly higher in Group-I than in Group-II. The mean hemoglobin drop was 1,73±0,95 for Group-I and 1,28±0,67 for Group-II (p < 0.05). The mean hematocrit drop was 5,17±2,76 for Group-I and 3,80±1,99 for Group-II (p < 0.05). Conclusion: On the basis of the results of the initial study, the antibiotic preference in patients undergoing surgery may be one of the bleeding factors during and after PCNL. doi: https://doi.org/10.12669/pjms.36.4.1977 How to cite this:Akkoc A, Aydin C, Ucar M, Topcuoglu M. Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics. Pak J Med Sci. 2020;36(4):---------.  doi: https://doi.org/10.12669/pjms.36.4.1977 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

scholarly journals Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsung-Hsin Chang ◽  
Wun-Rong Lin ◽  
Wei-Kung Tsai ◽  
Pai-Kai Chiang ◽  
Marcelo Chen ◽  
...  
Keyword(s):  
Shock Wave ◽  
Renal Stones ◽  
Disintegration Rate ◽  
Stone Size ◽  
Stone Free Rate ◽  
The Usa ◽  
Retreatment Rate ◽  
Ultrasound Assisted ◽  
Localization And Tracking ◽  
Free Rate

Abstract Background In this study, we aimed to compare the efficacy and clinical outcomes of shock wave lithotripsy (SWL) for patients with renal stones using pure fluoroscopy (FS) or ultrasound-assisted (USa) localization with two lithotripters. Methods We retrospectively identified 425 patients with renal calculi who underwent SWL with either a LiteMed LM-9200 ELMA lithotripter (209 cases), which combined ultrasound and fluoroscopic stone targeting or a Medispec EM-1000 lithotripter machine (216 cases), which used fluoroscopy for stone localization and tracking. The patient demographic data, stone-free rates, stone disintegration rates, retreatment rates and complication rates were analyzed. Results The USa group had a significantly higher overall stone-free rate (43.6 vs. 28.2%, p < 0.001) and stone disintegration rate (85.6 vs. 64.3%, p < 0.001), as well as a significantly lower retreatment rate (14.8 vs. 35.6%, p < 0.001) and complication rate (1.9 vs. 5.5%, p = 0.031) compared with the FS group. This superiority remained significant in the stone size < 1 cm stratified group. In the stone size > 1 cm group, the stone-free rate (32.4 vs. 17.8%, p = 0.028), disintegration rate (89.2 vs. 54.8%, p = 0.031) and retreatment rate (21.6 vs. 53.4%, p < 0.001) were still significantly better in the USa group, however there was no significant difference in the complication rate. The most common complication was post-SWL-related flank pain. Conclusion SWL is a safe and non-invasive way of treating renal stones. This study compared two electromagnetic shock wave machines with different stone tracking systems. LiteMed LM-9200 ELMA lithotripter, which combined ultrasound and fluoroscopic stone targeting outperformed Medispec EM-1000 lithotripter, which used fluoroscopy for stone localization and tracking, with better stone-free rates and disintegration rates, as well as lower retreatment rates and complications with possible reduced radiation exposure.

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.

Sign in / Sign up

Export Citation Format

Share Document