scholarly journals Percutaneous nephrolithotomy with or without nephrostomy tube

2018 ◽  
Vol 11 (2) ◽  
pp. 189
Author(s):  
Mohammed Aulad Hossain ◽  
S. M. Yunus Ali ◽  
Mohammad Saiful Islam ◽  
Mohammad Jahangir Alam ◽  
Mollah Md. Abu Sayed ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Disease ◽  
Nephrostomy Tube ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

<p class="Abstract">The study has been designed to compare the outcome of percutaneous nephrolithotomy with (Group A) or without nephrostomy tube (Group B) for the management of renal stone disease. JJ stents were given to all cases of both groups. Comparison of outcome between groups shows that urinary leakage time was significantly longer in Group B than that in Group A (24.0 ± 6.2 vs 7.3 ± 3.9 hours;  p&lt;0.001). Visual analogue pain score was also significantly high in Group B than in Group A (4.7 ± 0.8 vs 2.4 ± 0.5; p&lt;0.035). Patients in Group B stayed in hospital on an average 4 days, while the Group A patients stayed in hospital on an average 2.5 days (p&lt;0.029). The mean hemoglobin decrease in 24 hours in Group B and in Group A (0.5 ± 0.4 and 0.5 ± 0.4 respectively) did not show any significant difference (p&lt;0.895). In conclusion, percutaneous nephrolithotomy without nephrostomy tube can be practiced in the management of selective cases of renal stones diseases.</p>

scholarly journals Safety and Efficacy of Percutaneous Nephrolithotomy in The Treatment of Renal Stones in Children

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M A Badran ◽  
Y M Kotb ◽  
M K A Tolba
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Urinary Stone ◽  
Stone Disease ◽  
Age Group ◽  
Intraoperative Blood Loss ◽  
Urinary Stone Disease ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background the incidence of urinary stone disease has been increased due to the change in dietary habits, lifestyle factors and obesity. The prevalence of urinary stone disease was reported as 11.1% in the adult population, while the prevalence in children varies with age, it is approximately 2-3%. Open surgery was the only surgical treatment option in the past, now most pediatric urinary stones can be treated effectively by other procedures as extracorporial shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS) and laparoscopy. Aim of the Study to assess the safety and efficacy of percutaneous nephrolithotomy in the treatment of renal stones more than 15 mm in children aged 2-14 years old. Patients and Methods our study included 40 patients (28 males and 12 females) with a mean age (8.35 ± 3.69) with a range (2 to 14 years) managed by PCNL in 2 groups: Group A (Preschool age group): included 18 patients, 12 males (67%) and 6 females (33%) aged (2-6 years) managed by mini PCNL.Group B (School age group): included 22 patients, 16 male (73%) and 6 females (27%) aged (7-14 years) managed by standard PCNL. Results Success rate was nearly similar in both groups, it was 88.9% in group A and 95.5% in group B. Regarding the mean operative time it was 72.22 ± 12.63 in group A and 70.00 ± 15.74 in group B. Regarding the intraoperative blood loss it was more significant in group B with the mean intraoperative blood loss as 76.67 ± 15.34 in group A and 116.36 ± 22.79 in group B. Postoperative pain was more in group B than in group A, so 6 patients (33.3%) postoperative weak opiate analgesia in group A for less than 24 hours, while 16 patients (72.7%) needed postoperative weak opiate analgesia in group B. Hospital stay was 2.44 ± 0.51 in group A and 2.91 ± 1.02 in group B. Conclusion PCNL is a safe and effective procedure for management of renal stones in children, with accepted stone clearance rates and postoperative morbidity in addition to short hospital stay.

scholarly journals Comparison of Standard Percutaneous Nephrolithotomy with Mini-Percutaneous Nephrolithotomy for Removal of Renal Stones in Adults

2021 ◽  
Vol 5 (2) ◽  
pp. 20-25
Author(s):  
Asif Alam Khan ◽  
Inam Malkani ◽  
Junaid Jameel Khattak ◽  
Hassan Mumtaz ◽  
Mubashir Mazhar ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Treatment Time ◽  
Renal Stones ◽  
Hemoglobin Level ◽  
Stone Clearance ◽  
Group A ◽  
The Mean ◽  
Group B

Renal stones are the third most common problem affecting about 10% of global population. The management of nephrolithiasis has undergone a complete transformation since the 1980s. Percutaneous nephrolithotomy (PCNL) has established itself an effective and safe technique that delivers high stone-free rate as well as overall shorter treatment time. We aim to compare the outcome of mini-PCNL with standard-PCNL in patients presenting with renal stones. In all, 90 patients fulfilled the selection criteria and randomized into two groups. Group A underwent mini-PCNL whereas Group B underwent standard-PCNL. Pre-operative hemoglobin level was recorded. Duration of procedure as well as drop in hemoglobin level was also recorded. A kidney, ureter, and bladder (KUB) X-ray was performed to confirm the presence of of stone and stone-free status. The mean age of patients in mini-PCNL group was 43.11 years and in standard-PCNL group, it was 36.91 years. The mean stone size in patients of mini-PCNL group was 29.53 mm and 31.58 mm in standard-PCNL group. The mean duration of renal stone in mini-PCNL group was 1.91 years and that in standard-PCNL group 1.80 years. The mean operative time in mini-PCNL group was 59.56 min and 61.22 min in standard-PCNL group. The mean fall in hemoglobin in mini-PCNL group was 0.38 g/dL and that in standard-PCNL group 0.51 g/dL. In mini-PCNL group, stone clearance was observed in 42 (93.3%) patients, while in standard-PCNL group, it was observed in 45 (100%) patients. This difference was insignificant (P > 0.05). Mini-PCNL and standard-PCNL have no significant differences in terms of outcome, operative time, and stone clearance, although fall in hemoglobin level was less in mini-PCNL group, which showed less blood loss in this group, thereby making it a more appropriate method for renal stone removal.  

scholarly journals TUBELESS PERCUTANEOUS NEPHROLITHOTOMY;

2013 ◽  
Vol 20 (05) ◽  
pp. 787-792
Author(s):  
MUHAMMAD NASIR IBRAHIM ◽  
MUHAMMAD MUZAMMIL TAHIR ◽  
AMJAD ALI SADDIQUE ◽  
Mohammad Usman Khan
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Nephrostomy Tube ◽  
Dose Requirement ◽  
Ureteric Catheter ◽  
Analgesic Dose ◽  
Analgesia Requirement ◽  
Group A ◽  
Group B ◽  
Tubeless Pcnl

Revolutionary advances in the minimally invasive and non invasive management of stone disease over the past twodecades have greatly facilitated the removal of stones. Renal stone management moved from open surgery to minimally invasiveprocedures with the aim of achieving maximum stone clearance with the least morbidity and mortality. Percutaneous nephrolithotomy(PCNL) remains the most efficient procedure in all patient groups. Tubeless PCNL is increasing in popularity and the technique ofpercutaneous nephrolithotomy is in constant evolution. Nephrostomy tube has been implicated in causing postoperative discomfort orpain and morbidity. Nephrostomy-free or tubeless PCNL reduces postoperative pain and analgesia related to the drainage tube. Objective:To compare mean analgesia requirement with tubeless PCNL and standard PCNL in renal stone patients Study design: Randomizedcontrolled trial conducted at Shaikh Zayed Hospital Lahore from July 2010 to January 2011. Methods: 100 patients were divided into twogroups randomly by using random number tables i.e. 50 patients in group A and 50 patients in group B. Group A patients were operated bystandard PCNL method i.e. with Placement of nephrostomy tube and ureteric catheter and group B were operated by tubeless PCNL i.e.without nephrostomy tube but with ureteric catheter. The data was collected on attached predesigned computer based proforma. Results:The analgesic dose requirement in Group A was 116.50± 26.55mg and analgesic dose requirement in Group B was 73.00±30.24mg ofpethidine. So, analgesia requirement in both groups showed a significant difference (p<0.05). Conclusions: Tubeless PCNL can be usedwith a favorable outcome in renal stone patients, with the potential advantage of decreased analgesia requirement.

scholarly journals COMPARISON OF LOCAL METHYLCOBALAMINE INJECTION VERSUS LOCAL BUPIVACAINE INJECTION FOR THE TREATMENT OF ACUTE HERPETIC NEURALGIA

2022 ◽  
Vol 71 (6) ◽  
pp. 2228-2231
Author(s):  
Ghazala Yasmin ◽  
Naeem Raza ◽  
Arfan -Ul- Bari ◽  
Farah Yousaf ◽  
Summaya Saleem ◽  
...  
Keyword(s):  
Pain Score ◽  
Subcutaneous Injection ◽  
Visual Analogue Score ◽  
Military Hospital ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the reduction in mean pain score with local Methylcobalamin injection versus local Bupivacaine injection in patients with acute herpetic neuralgia. Study Design: Quasi experimental study. Place and Duration of Study: Dermatology Outpatient Department, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2019. Methodology: Total 100 patients, having pain score more than 3, fulfilling the selection criteria were divided into two groups. Group A was treated with daily subcutaneous injection Bupivacaine, whereas Group B was treated with daily subcutaneous injection Methycobalamin at the site of neuralgia. Patients were followed up for 4 weeks. The pain score was noted. All the data was entered and analyzed on SPSS version 21. Results: In this study mean age of patients in group A was 43.82 ± 15.76 years and in group B was 44.76 ± 16.92 years. The mean visual analogue pain score at 4th week in the group A patients was 1.14 ± 0.32 and in group B was 1.90 ± 0.97. Statistically significant difference was found in group A (local Bupivacaine) with visual analogue score (VAS) at 4th week (pvalue=0.002). Conclusion: The local Bupivacaine injection showed significant reduction in mean pain score than local Methylcobalamin injection in patients with acute herpetic neuralgia.

A COMPARISON OF DEXMEDETOMIDINE AND FENTANYL AS AN ADJUVANT TO 0.25% BUPIVACAINE FOR EPIDURAL ANALGESIA IN PERCUTANEOUS NEPHROLITHOTOMY (PCNL)

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Maya Damor ◽  
Pinki Meena ◽  
Trishala Jain ◽  
Anupama Gupta
Keyword(s):  
General Anesthesia ◽  
Percutaneous Nephrolithotomy ◽  
Epidural Anaesthesia ◽  
Sensory Block ◽  
Research Review ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: PCNL can be performed under general anesthesia or regional anesthesia. PCNL is usually performed under general anesthesia due to better control of breathing and more comfort for the patients. Methods: The study was conducted on 75 patients devided in 3 groups (n=25 in each group) undergoing PCNL. After obtaining permission from Research review board and institutional ethics committee. Informed and written consent was obtained from all patients for performance of epidural anaesthesia after complete explanation about the study protocol, side effects related to the drugs and procedure to the patient. Results: The onset of sensory block was comparable in group B(7.28 ± 0.93min) and group C (6.88 ± 0.97min) , faster when compared to group A (8.16 ± 0.85min) group. The mean time of onset of motor block was comparable in group C (18.08 ± 1.41min) and group B (20.56 ± 1.61min) but slightly faster when compared to group A (26.08 ± 1.19min) group. The mean VAS score was lower in GroupC followed by GroupB and was highest in GroupA from 2hours to 5hours after surgery. Sedation score was significant higher in Group C (p<0.001) as compared to Group A and B and there was no significant difference between Group A and B. Conclusion: We conclude that PCNL can be performed using 0.25% bupivacaine in epidural anaesthesia without compromising on patient's comfort and surgeon's satisfaction. Keywords: Percutaneous nephrolithotomy (PCNL), Dexmedetomidine, Fentanyl, Bupivacaine

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 Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

Tubeless Percutaneous Nephrolithotomy with Hemostatic Plug Using Surgiflo® versus Standard Percutaneous Nephrolithotomy using a Nephrostomy Tube: A Prospective Randomized Controlled Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hisham Mohamed Fathey Elshawaf ◽  
Mohamed Ismail Shabayek ◽  
Mohamed Ahmed Saleh Ahmed
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Intraoperative Complications ◽  
Demographic Data ◽  
Renal Stones ◽  
Controlled Study ◽  
P Value ◽  
Nephrostomy Tube ◽  
Gelatin Matrix ◽  
Significant Difference ◽  
Tubeless Pcnl

Abstract Background Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large renal stones (over 2cm in diameter). It involves keyhole surgery performed through a small skin incision overlying the kidney. Objectives Our study aimed at evaluating the safety and efficacy of local hemostatic sealant (surgiflo®) use in tubeless PCNL to enhance postoperative outcomes of PCNL. Patients and Methods We randomized our patients into two groups, Group A nephrostomy tube was used as standard PCNL, and at group B tubeless PCNL was done followed by injection of the local hemostatic flowable gelatin matrix (surgiflo®) under fluoroscopic guidance in the prone position Results There was no statistically significant difference between two groups regarding demographic data age, sex and BMI (P- value 0.280, 0.736 and 0.440 respectively), stone site and size (P- value 0.525 and 0.533 respectively), operative time (P- value 0.855), intraoperative complications as blood loss and pelvicalyceal perforation, (P- value 0.92 and P- value 0.83 respectively), postoperative complication as fever, haematuria and UTI (P- value 1.000, 0,113 and 1.000 respectivly), and Hb drop (P- value 0.735). Conclusion Tubeless PCNL with hemostatic sealant use is associated with less pain, no leakage from nephrostomy tract, less narcotic agent use, and a shorter hospital stay.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaolin Wang ◽  
Ke Tang ◽  
Tianji Huang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinous Process ◽  
Bone Grafts ◽  
Clinical Results ◽  
Single Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

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