Seoul National University Renal Stone Complexity Score for Predicting Stone-Free Rate after Percutaneous Nephrolithotomy

Background: Urolithiasis is one of the common diseases of the urinary system, with an incidence of approximately 5-10% among the general population. Among the minimally invasive surgeries, percutaneous nephrolithotomy (PCNL) is the gold standard therapy for large and/or complex renal stones. Objective: The study was carried out to predict the stone-free rate after PCNL by using the Guy's stone score. Methods: This prospective cross-sectional study was conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, (BSMMU), Dhaka from February 2016 to January 2017. The patients with renal stone attending the outpatient department who met the criteria of standard PCNL. Results: Atotal of 52 patients with renal stone were included in this study. The mean age was to be found 45.3±14.0 with range of 18 to 73 years. Male to female ratio was 3.3:1. Almost three fourth (74.5%) patients had normal body mass index. All patients had normal anatomy. More than half 27 of the (51.9%) patients had found grade I, 10 (19.2%) Grade II, 11(21.2%) Grade III and 4 (7.7%) Grade IV. Nearly two third 34 (65.4%) patients were found total stone cleared and 18(34.6%) had residual stone. Cleared stone was found 23(85.2%) in grade I, 7(70.0%) grade II, 3(27.3%) in grade III and 1(25.0%) in grade IV. Conclusion: Based on the study findings, it may be concluded that higher the GSS less the stone free rate.It will help in better patient counseling preoperatively, and to predict the need for ancillary treatment.

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Flank Suspended Supine Position for Percutaneous Nephrolithotomy

Urologia Journal ◽

10.5301/ru.2012.9024 ◽

2012 ◽

Vol 79 (1) ◽

pp. 58-61 ◽

Cited By ~ 4

Author(s):

Pan Tie-jun ◽

Li Gong-cheng ◽

Ye Zhang-qun ◽

Wen Han-dong ◽

Shen Guo-qiu ◽

...

Keyword(s):

Percutaneous Nephrolithotomy ◽

Supine Position ◽

Renal Stone ◽

Pleural Cavity ◽

Operation Time ◽

Bleeding Rate ◽

Extracorporeal Shock Wave ◽

Stone Free Rate ◽

Positioning Method ◽

Free Rate

Aims Prone and supine positions for percutaneous nephrolithotomy are widely used but have their drawbacks. We report a new positioning method called “flank suspended supine position” (FSSP) for PCNL and describe our experience with PCNL in this position to evaluate its safety and efficacy. Methods Retrospective study of 150 cases of renal stone patients treated with PCNL in a new position called flank suspended supine position (FSSP) from June 2009 to July 2010. All patients were treated with PCNL in FSSP under epidural anesthesia. Operation time, bleeding rate, stone free rate, and complications were recorded. Results All patients tolerated FSSP. Mean operation time was 78.29±26.13 min. Initial stone-free rate was 83%. For those with residual stones (26 cases), 18 were stone-free after a second PCNL, 8 after extracorporeal shock wave lithotripsy (ESWL). Mean hospital stay was 7.63±2.39 days. No penetrating injury of the pleural cavity or injury to visceral organs was reported. Summary FSSP is an effective and safe position for PCNL in our hands and its effectiveness relative to traditional prone position needs to be determined in future randomized studies.

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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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The Safety and Efficacy of Mini Percutaneous Nephrolithotomy During Learning Curve

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v18i2.21355 ◽

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.

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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

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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Modified Seoul National University Renal Stone Complexity score for retrograde intrarenal surgery

Urolithiasis ◽

10.1007/s00240-014-0650-7 ◽

2014 ◽

Vol 42 (4) ◽

pp. 335-340 ◽

Cited By ~ 24

Author(s):

Jin-Woo Jung ◽

Byung Ki Lee ◽

Yong Hyun Park ◽

Sangchul Lee ◽

Seong Jin Jeong ◽

...

Keyword(s):

Renal Stone ◽

Retrograde Intrarenal Surgery ◽

Complexity Score ◽

National University ◽

Seoul National University

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Percutaneous nephrolithotomy-a versatile technique for both simple and complex renal stone

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v39i3.20308 ◽

2014 ◽

Vol 39 (3) ◽

pp. 99-103

Author(s):

TMS Hossain ◽

M Asaduzzaman ◽

MN Uddin ◽

MH Rahman ◽

MU Jahan ◽

...

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Age Groups ◽

Renal Calculi ◽

First Line ◽

Stone Size ◽

Stone Free Rate ◽

Versatile Technique ◽

Free Rate ◽

Puncture Technique

Percutaneous Nephrolithotomy is currently the preferred first line treatment for simple & complex renal calculi. The technique also being used increasingly for smaller stones that have failed ESWL. Aim of the study is to share our experience in PCNL in course of time. This study was conducted from January 2009 to December 2012, 131 patients with 142 renal units of 5-75 yrs of age, PCNL were performed in NIKDU, BSMMU & JBFH. Stone were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete staghorn stones, renal pelvic stone with accompanying calyceal stones). The stone size was 1.5-5cm approximately. We asses our initial puncture technique, need for multi-tract, supra 12th rib access, stone free rate, operative duration, postoperative complication, number of transfusion and hospital stay. Operative durations were 60 min -180 minutes. Puncture technique improved in course of time. 14 patients need multi-puncture and tract, all are supra 12th access. Out of 142 renal units 120 (83%) were stone free after first procedure, another 22 need and auxiliary procedure, (5 2nd look PCNL, 6 URS, 11 ESWL) to become stone free result in a 95% stone free rate. Complications occurred in 17 procedures which dealt accordingly. This study revealed PCNL is an effective, versatile safe and cosmetically acceptable procedure for all age groups in simple and complex renal stone. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20308 Bangladesh Med Res Counc Bull 2013; 39: 99-103

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

Journal of International Medical Research ◽

10.1177/0300060520983136 ◽

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.

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Impact of weight on stone-free rate during percutaneous nephrolithotomy

African Journal of Urology ◽

10.1186/s12301-020-00071-4 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Abdrabuh M. Abdrabuh

Keyword(s):

Percutaneous Nephrolithotomy ◽

Operative Procedure ◽

World Health ◽

Fluoroscopy Time ◽

Morbidly Obese ◽

Obese Patients ◽

Co Morbidity ◽

Stone Free Rate ◽

Morbid Obese ◽

Free Rate

Abstract Background To assess Impact of weight on stone-free rate during percutaneous nephrolithotomy. Methods Hundred and twenty-three PNL procedures were done between January 2016 and July 2017. The patients were divided into four groups according to the World Health Organization (WHO) classification of body mass index (BMI): < 25 ((group 1, average)), 25–29.9 (group 2, overweight), 30–39.9 (group 3, obese), and ≥ 40 kg/m2 (group 4, morbidly obese). All groups were compared as regarding preoperative variables, intra-operative procedure and postoperative results. Results The non-obese groups were younger in age than obese and morbid obese groups (P = 0.005). The difference in BMI was statistically significant between non-obese and obese groups (P = 0.0001). Most of females gender were obese and morbid obese (P = 0.0001) and most of the obese patients had left-sided renal stone (P = 0.001). Most of overweight and obese groups had radiopaque stones (P = 0.02). There were no statistically significant differences between all groups as regarding co-morbidity, stone size, stone locations, and hydronephrosis grade. Operative time (P = 0.034), length of hospital stay (P value = 0.014) and fluoroscopy time (P = 0.0001) were statistically significant differences between all groups. Number of accesses, access site, postoperative hemoglobin drop, post- operative complications, fate of residual stones and stone-free rate were not statistically significant differences between all groups. BMI was correlated with mean fluoroscopy time and mean hospitalization duration in our study as the time of hospitalization and time of x-ray exposure increase with obesity. Conclusion PNL is a safe and effective procedure for obese patients. BMI do not predict clearance post PNL.

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