scholarly journals Tubeless versus common minimally invasive percutaneous nephrolithotomy for renal stones under local anesthesia: analysis of clinical outcomes

2020 ◽  
Author(s):  
GenYi Qu ◽  
Yong Xu ◽  
Cheng Tang ◽  
JinGe Liu ◽  
HaiBo Nie ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Local Anesthesia ◽  
Percutaneous Nephrolithotomy ◽  
Removal Rate ◽  
Operation Time ◽  
Renal Stones ◽  
Postoperative Fever ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Vas Scores ◽  
Group 2

Abstract Background: To compare the clinical outcomes of tubeless minimally invasive percutaneous nephrolithotomy（mPCNL）and common minimally invasive percutaneous nephrolithotomy under local anesthesia, and to explore the feasibility, safety and clinical efficacy of tubeless mPCNL under local anesthesia. Methods: Patients with PCNL who underwent local anesthesia from January 1, 2018 to November 30, 2018. The patients were divided into Group 1 (tubeless mPCNL: indwelling double J tube, no indwelling nephrostomy tube) and group 2 (common mPCNL: indwelling double J tube and nephrostomy tube). The intraoperative and postoperative parameters of the two groups were compared, including operation time, average postoperative hospital stay, puncture position, postoperative hemoglobin decline, postoperative visual analogue scale (VAS), analgesic use, postoperative fever and stone removal rate. Results: In group1,the VAS scores of 6 hours after surgery was 4.07±1.79 significantly lower than that for group 2 (4.07±1.79 vs 6.24±1.33, P<0.05). and There was a statistically significant difference in the use of analgesics between the two groups（P<0.05）. The VAS scores of day 1 after surgery (2.50±1.76 vs 3.83±2.22 in group1 and group2) was significantly lower in the tubeless mPCNL (P<0.05). The hospital stay for group 1 was significantly shorter than group 2(3.15±1.42 vs 6.48±1.88 days, P<0.01)). There were no significant differences in the operation time, puncture position, postoperative hemoglobin decline rate, VAS score on the day of discharge, postoperative fever, and stone removal rate between the two groups (P>0.05). Conclusion: Tubeless mPCNL is a simple, safe and effective technique under local anesthesia. It is worthy of clinical application. Tubeless mPCNL treatment for renal stones can significantly reduce postoperative pain and shorten hospital stays compared with common m PCNL.

Double-Sheath Vacuum Suction Minimally Invasive Percutaneous Nephrolithotomy for Management of Large Renal Stones

2021 ◽  
pp. 1-5
Author(s):  
Zhong-Hua Wu ◽  
Yong-Zhi Wang ◽  
Tong-Zu Liu ◽  
Xing-Huan Wang ◽  
Hang Zheng ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Renal Stones ◽  
Vacuum Suction ◽  
Conventional Procedure ◽  
Outer Sheath ◽  
Stone Free Rate ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Free Rate

<b><i>Objectives:</i></b> This study aimed to describe a novel double-sheath vacuum suction minimally invasive percutaneous nephrolithotomy (mini-PCNL) to overcome the deficiencies of the conventional procedure. <b><i>Patients and Methods:</i></b> Between March 2019 and December 2019, 65 patients (37 males and 28 females) with a mean age of 41 years (range 23–69) underwent mini-PCNL with double-sheath vacuum suction. It consisted of an F20 Y-shaped sheath as an outer sheath and an F16 Y-shaped sheath as an inner sheath, in which the inner sheath was longer than the outer sheath. The oblique arm of the outer sheath and the inner sheath was connected to the perfusion inflow and the vacuum suction, respectively. A 550-μm holmium-YAG laser was introduced for stone fragmentation through the working channel of the mini-nephroscope, which was no longer connected to the perfusion fluid. <b><i>Results:</i></b> All procedures were successful. Mean operation time was 50.2 min (range 39–83). Mean hemoglobin decrease was 5.2 g/L (range 1.0–15.5), and no patient needed a blood transfusion. One patient (1.5%) with low fever (&#x3c;38°C) at day 1 had returned to normal at day 2 without administration of antibiotics. There were no Clavien grade 2–4 complications. Mean postoperative hospital stay was 2.4 days (range 2–6). The initial stone-free rate of PCNL was 81.53% (53 of 65 patients). One month after surgery, the final stone-free rate increased to 90.77% (59/65 patients). <b><i>Conclusions:</i></b> The double-sheath vacuum suction mini-PCNL is a safe and effective modality for large renal stones, which might increase the efficiency of stone extraction with low intrapelvic pressure.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

scholarly journals The Outcomes of Minimally Invasive Percutaneous Nephrolithotomy with Different Access Sizes for the Single Renal Stone ≤25 mm: A Randomized Prospective Study

2021 ◽  
pp. 1-6
Author(s):  
Weimin Yu ◽  
Yuan Ruan ◽  
Zhuang Xiong ◽  
Yunlong Zhang ◽  
Ting Rao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Controlled Trial ◽  
Demographic Data ◽  
Operation Time ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Free Rate

<b><i>Objectives:</i></b> The aim of this study was to provide a randomized controlled trial comparing the outcomes of different access sizes used in the solo ultrasonic-guided minimally invasive percutaneous nephrolithotomy (mini-PCNL). <b><i>Methods:</i></b> From January 2018 to December 2019, a total of 160 cases with single renal stones of &#x3c;25 mm were randomized to undergo mini-PCNLs with Fr16, Fr18, Fr20, or Fr22 accesses. All accesses were established with the axis of the target calyx as the marker for puncture location and then expanded to the desired size. Hemoglobin reduction, operative time, stone-free rate, complications, etc., were all recorded and assessed. <b><i>Results:</i></b> The demographic data were similar, and there were no significantly intergroup differences in stone-free rate, complications, and hospital stay time. The hemoglobin reduction was comparable and was 0.9 ± 0.6, 0.9 ± 0.7, 1.0 ± 0.5, and 1.1 ± 0.7 g/dL for the groups Fr16, Fr18, Fr20, and Fr22, respectively. The operative time was 53.4 ± 14.5, 48.5 ± 15.2, 42.8 ± 13.3, and 43.3 ± 13.1 min for the 4 groups, which decreased significantly from group Fr16 to Fr20, but there was no significant difference between Fr20 and Fr22 groups. <b><i>Conclusions:</i></b> The axis of target calyx is a reliable marker for establishment of percutaneous renal access under ultrasonic guidance. The surgical outcomes of different access sizes were comparable, but the operation time was significantly shortened with the increase of size. However, Fr22 was not more efficient than Fr20.

scholarly journals Minimally Invasive Percutaneous Nephrolithotomy in Management of Lower Pole Renal Stones 2cm or Less

2018 ◽  
Vol 86 (12) ◽  
pp. 4525-4529
Author(s):  
MOHAMED ABD EL-WAHED, M.D.; AHMED M. SHOUMAN, M.D. ◽  
ASHRAF MOSHARAFA, M.D.; AHMED A. MORSY, M.D.
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Lower Pole ◽  
Minimally Invasive Percutaneous Nephrolithotomy

scholarly journals The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Xiangjun Meng ◽  
Juan Bao ◽  
Qiwu Mi ◽  
Shaowei Fang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Minimally Invasive ◽  
Logistic Regression Analysis ◽  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Stone Size ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Staghorn Stone

Objective. This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods. The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results. A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions. Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.

Modified tubeless minimally invasive percutaneous nephrolithotomy for management of renal stones in children

2019 ◽  
Vol 18 (1) ◽  
pp. e572
Author(s):  
A. Sebaey Ahmed Moustafa ◽  
A. Mohamed Abdal-Aal Hasan ◽  
A. Abdelrazek Ali El-Shaer ◽  
E. Mohamed Ali El-Barky ◽  
W. Saber Kandeel ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Minimally Invasive Percutaneous Nephrolithotomy
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