Emergency percutaneous nephrostomy versus emergency percutaneous nephrolithotomy in patients with sepsis associated with large uretero-pelvic junction stone impaction: a randomized controlled trial

Abstract Introduction Percutaneous nephrolithotomy (PCNL) is the standard surgical treatment method for large kidney stones. Its aim is to achieve a stone-free status, since any residual fragments (RFs) after PCNL are likely to cause additional morbidity or stone growth. Enhancing intraoperative detectability of RFs could lead to increased stone-free rates and decreased re-intervention rates. Cone beam computed tomography (CBCT) has recently been introduced in urology as a feasible method for intraoperatively imaging RFs. The aim of this trial is to determine the added value of CBCT in percutaneous nephrolithotomy, by measuring differences in stone-related morbidity for patients with procedures in which a CBCT is used versus patients with procedures without the use of CBCT. Methods The CAPTURE trial is an investigator-initiated single-center, randomized controlled trial (RCT) in adult patients who have an indication for percutaneous nephrolithotomy. A contemporary percutaneous nephrolithotomy is performed. Once the surgeon is convinced of a stone-free status by means of fluoroscopy and nephroscopy, randomization allocates patients to either the study group in whom an intraoperative CBCT scan is performed or to the control group in whom no intraoperative CBCT scan is performed. The main endpoint is the stone-free status as assessed four weeks postoperatively by low-dose non-contrast abdominal CT, as a standard follow-up procedure. Secondary endpoints include the number of PCNL procedures required and the number of stone-related events (SREs) registered. The total study population will consist of 320 patients that undergo PCNL and are eligible for randomization for an intraoperative CBCT scan. Discussion We deem a randomized controlled trial to be the most effective and reliable method to assess the efficacy of CBCT in PCNL. Though some bias may occur due to the impossibility of blinding the urologist at randomization, we estimate that the pragmatic nature of the study, standardized circumstances, and follow-up methods with pre-defined outcome measures will result in a high level of evidence. Trial registration Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Registered on 15 October 2019. Prospectively registered.

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Preventing Excessive Blood Loss During Percutaneous Nephrolithotomy by Using Tranexamic Acid: A Double Blinded Prospective Randomized Controlled Trial

Journal of Urological Surgery ◽

10.4274/jus.1589 ◽

2017 ◽

pp. 195-201 ◽

Cited By ~ 3

Author(s):

Adnan Siddiq ◽

Salman Khalid ◽

Hammad Mithani ◽

Shariq Anis ◽

Imran Sharif ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Blood Loss ◽

Tranexamic Acid ◽

Percutaneous Nephrolithotomy ◽

Controlled Trial ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Double Blinded ◽

Excessive Blood Loss

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Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial

Urolithiasis ◽

10.1007/s00240-021-01289-9 ◽

2021 ◽

Author(s):

Maged Kamal Fayad ◽

Omar Fahmy ◽

Khaled Mukhtar Abulazayem ◽

Nashaat M. Salama

Keyword(s):

Randomized Controlled Trial ◽

Percutaneous Nephrolithotomy ◽

Controlled Trial ◽

Retrograde Intrarenal Surgery ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

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Effectiveness of Aromatherapy for Relief of Pain, Nausea, and Vomiting after Percutaneous Nephrolithotomy: A Randomized Controlled Trial

Complementary Medicine Research ◽

10.1159/000508333 ◽

2020 ◽

Vol 27 (6) ◽

pp. 440-448

Author(s):

Mojdeh Amirhosseini ◽

Mahlagha Dehghan ◽

Parvin Mangolian Shahrbabaki ◽

Hamid Pakmanesh

Keyword(s):

Clinical Trial ◽

Randomized Controlled Trial ◽

Percutaneous Nephrolithotomy ◽

Complementary Therapies ◽

Controlled Trial ◽

The Other ◽

Nausea And Vomiting ◽

Control Group ◽

Analog Scale ◽

Randomized Controlled

Background: Postoperative pain, nausea, and vomiting are common side effects of percutaneous nephrolithotomy. Nowadays, non-pharmacological and complementary therapies have been noticed. Therefore, a study was conducted to determine the effectiveness of lavender and clary sage on the pain, nausea, and vomiting after percutaneous nephrolithotomy. Methods: This is a randomized clinical trial study on 79 patients undergoing percutaneous nephrolithotomy. Patients were randomly divided into three groups of lavender aromatherapy (n = 27), clary sage aromatherapy (n = 26), and a control group (n = 26). Each of the intervention groups received the inhalation aromatherapy immediately and 3 and 6 h after the operation. Pain, nausea, and emetic episodes in patients of the three groups were measured before the intervention and 30 min after each intervention using a visual analog scale and checklist. Results: Pain decreased significantly in the clary sage aromatherapy group. Nausea had a downward trend in the two groups of aromatherapy. The lavender aromatherapy group had the lowest incidence of emetic episodes compared to the other groups. Conclusion: Regarding the annoying pain, nausea, and vomiting after percutaneous nephrolithotomy for patients, and taking into account the complications of drug therapy, the use of complementary non-pharmacological methods can help increase the comfort of patients.

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