scholarly journals Tract Size in Percutaneous Nephrolithotomy (PCNL) : Does It Really Matter?

2020 ◽  
Vol 18 (2) ◽  
pp. 18-22
Author(s):  
Mofizur Rahman ◽  
Mohammed Monowar Ul Hoque ◽  
Kazi Md Monwarul Karim ◽  
AKM Akramul Bari ◽  
Tanvir Rahman ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Statistical Difference ◽  
Pain Perception ◽  
Operative Time ◽  
Previous History ◽  
Postoperative Fever ◽  
Stone Clearance ◽  
Significant Difference

Background : Percutaneous Nephrolithotomy (PCNL) is the treatment of choice in removal of renal and proximal ureteral calculi. The primary goal of PCNL is to achieve stone free status while minimizing morbidity and complications. In recent years, the instruments used have been miniaturized in an effort to decrease morbidity associated with standard PCNL as well as increase the efficacy of stone removal. The aim of this study is to compare the safety and efficacy of PCNL using different tract size. Materials and methods: This hospital based prospective interventional study was conducted on patients with 1 to 4 cm renal stones who underwent PCNL either by Minior Standard PCNL technique in Chattogram Medical College Hospital and different private hospitals in Chittagong from July 2016 to June 2018. Patients aged above 12 years of age, irrespective of gender with normal renal function were evaluated to compare stone clearance, total operative time, need for blood transfusion, postoperative pain and other complications. Those who had previous history of open renal surgery, active urinary tract infection, renal malformation, uncorrected coagulopathy and morbid obesity were excluded. Results: A total of 64 patients were enrolled consecutively for PCNL who were divided equally into two groups randomly for minimally invasive PCNL (Mini- PCNL) and Standard PCNL. The average stone size in mini-PCNL group was 2.64 ± 0.94 cm and 2.776 ± 0.97 cm in standard-PCNL group. Mean tract size was 18.44 ± 1.32 F (16-20) and 26.7 ± 5 F (24-30) respectively. In mini-PCNL operative time was significantly longer than that of standard PCNL with 110.31 ± 21.77 vs 95.94 ± 19.82 min respectively. Conversely, there was an advantage of mini-PCNL over the standard one in terms of a significantly reduced hemoglobin drop (0.5 ± 0.25 vs. 0.8 ± 0.34) gram and hospital stay (2.13 ± 0.79 vs.3.38 ± 1.13 days) respectively though there was no statistical difference in terms of stone clearance rates between two groups (86.7% vs. 93.33%). There was no statistical difference in terms of Visual Analogue Scale (VAS) score (5.44 ± 1.5 vs.6.19 ± 1.65) for pain perception. The complication rate of mini-PCNL had no significant difference with that of standard PCNL (10% vs 13.6%). No statistical difference was recorded in terms of postoperative fever (³38oC) between two groups (2 in each group, 6.67%, p=1). Blood transfusion requirement was much less in mini PCNL group (10% vs. 33.33%). Conclusion: In addition to minimal bleeding and excellent stone clearance, mini- PCNL has several features for which it should be considered as an alternative or adjunct to standard PCNL, URS and ESWL. These include safe supra-costal puncture, excellent access to nearly all calyces and upper ureter, less hospital stay and suitable for large stones also. Future studies should continue to refine methods to assess complexity and safety and to determine consensus on the use of mini- PCNL. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 18-22

scholarly journals Miniaturization of PCNL; Necessity or What?

2020 ◽  
Vol 23 (1) ◽  
pp. 11-16
Author(s):  
Mofizur Rahman ◽  
Mohammed Monowar Ul Hoque ◽  
Kazi Mohammad Monwarul Karim ◽  
AKM Akramul Bari ◽  
Md Asaduzzaman Asad ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Statistical Difference ◽  
Operative Time ◽  
Previous History ◽  
Access Time ◽  
P Value ◽  
Postoperative Fever ◽  
Stone Clearance ◽  
Significant Difference

Objective: Now a days, percutaneous nephrolithotomy (PCNL) is the treatment of choice for retrieval of renal and proximal ureteral calculi. The primary goal of PCNL is to achieve stone free status while minimizing morbidity and complications. In recent years, the instruments used have been miniaturized in an effort to decrease morbidity associated with standard PCNL as well as increase the efficacy of stone removal. The aim of this study was to compare the safety and efficacy of PCNL using different tract size. Patients and Methods: This hospital based prospective interventional study was conducted on patients with 1 to 4 cm renal stones who underwent PCNL either by Mini or by Standard PCNL technique in Chattogram Medical College Hospital and different private hospitals in Chattogram from July 2016 to October 2018. Patients aged above 12 years of age, irrespective of gender with normal renal function were evaluated to compare stone clearance, access time, fluoroscopy time for access, total operative time, need for blood transfusion, postoperative hospital stay, postoperative pain, fever, urinary leakage and other complications between two groups. Those who had previous history of open renal surgery, active urinary tract infection, renal malformation, uncorrected coagulopathy and morbid obesity were excluded. Results: A total of 78 patients were enrolled consecutively for PCNL who were divided equally into two groups randomly for minimally invasive PCNL (Mini-PCNL) and Standard PCNL. The average stone size in mini-PCNL group was 2.59±0.89 cm, and 2.66±0.97 cm in standard-PCNL group (p=0.7). Mean tract size was 18.53 ± 1.29 F (16-20) and 26.11 ± 4.61 F (24-30) respectively with P value <0.001. In mini-PCNL operative time was significantly longer than that of standard PCNL with 112.11 ± 20.29 vs. 98.68± 19.75 minutes respectively with p=.004. Conversely, there was an advantage of mini-PCNL over the standard one in terms of a significantly reduced hemoglobin drop (0.5 ± 0.26 vs. 0.83 ± 0.32 gm%, p value 0.001) and hospital stay (2.18 ± 0.77 vs. 3.39 ± 1.10 days, p value= 0.001), respectively though there was no statistical difference in terms of stone clearance rates between two groups (86.84% vs. 92.11%, p=0.45). There was no statistical difference in terms of visual analogue scale (VAS) score (5.55±1.54 vs. 6.24±1.6) for pain perception. The complication rate of mini-PCNL had no significant difference with that of standard PCNL (10.52% vs 12.50%, p=0.72). No statistical difference was recorded in terms of postoperative fever (eŠ38C) between two groups (2 in each group, 5.2%, p=1 Blood transfusion requirement was much less in mini PCNL group (10.52% vs. 34.2%, p=0.01). Conclusion: In addition to minimal bleeding and excellent stone clearance, mini- PCNL has several features for which it should be considered as an alternative or adjunct tostandard PCNL, URS, and ESWL. These include safe supra-costal puncture, excellent access to nearly all calyces and upper ureter, less hospital stay and suitable for large stones also. Future studies should continue to refine methods to assess complexity and safety and to determine consensus on the use of mini- PCNL. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.11-16

Comparison of Retrograde Intrarenal Surgery and Micro-Percutaneous Nephrolithotomy for Kidney Stones: A Meta-Analysis

2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Gu ◽  
Yucheng Yang ◽  
Rui Ding ◽  
Meili Wang ◽  
Jianming Pu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
Retrograde Intrarenal Surgery ◽  
Alternative Approach ◽  
Significant Difference

<b><i>Background:</i></b> Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. <b><i>Objectives:</i></b> The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. <b><i>Methods:</i></b> A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. <b><i>Results:</i></b> Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, <i>p</i> = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, <i>p</i> = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, <i>p</i> = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, <i>p</i> &#x3c; 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, <i>p</i> = 0.04) when comparing RIRS with micro-PCNL. <b><i>Conclusions:</i></b> Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.

scholarly journals Comparative Study Between Percutaneous Nephrolithotomy and Extra Corporeal Shock Wave Lithotripsy in Managing Renal Stones

2014 ◽  
Vol 41 (3) ◽  
pp. 23-27
Author(s):  
MS Islam ◽  
NP Biswas ◽  
MZ Hossan ◽  
I Rahman ◽  
AKM K Alam ◽  
...  
Keyword(s):  
Shock Wave ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Cutaneous Fistula ◽  
Stone Clearance ◽  
Post Procedure ◽  
Significant Difference

To find out better treatment option in treating renal stone safely, expeditiously. A total of 90 patient were prospectively randomized for Percutaneous Nephrolithotomy (PCNL) (40) and Extra Corporeal Shock Wave Lithotripsy (ESWL) (50). Stone clearance, adjuvant procedures, hospital stay, post procedure morbidity, were compared for both methods. Stone clearance in PCNL and ESWL group was 87.50 and 66 percent respectively with a significant difference of clearance (P<0.05). Considering the stone size, in smaller stones, clearance was 87.50% and 72 50% among PCNL and ESWL group respectively without any significant difference (P>0.05). But in larger stones, stone clearance was 87.50% and 60.72% among PCNL and ESWL group respectively with significant difference in clearance between the groups (P<0.05). The rate of adjuvant procedures in PCNL and ESWL group was 12.50%, and 34% respectively. Requirement of adjuvant procedures were significantly higher in ESWL group (P<0.051 Post procedure hospital stay was significantly shorter in ESWL group than PCNL group (1.32 0.47 vs 4.52 1.99) with P yalue <0 05. Steinstrasse and Haematuria were significantly higher in ESWL group than PCNL group. Bleeding requiring transfusion, urinary cutaneous fistula and .fever were significantly higher in PCNL group than ESWL group. PCNL is more effective than ESWL in clearing larger renal stones. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18954 Bangladesh Medical Journal 2012 Vol.41(3): 23-27

scholarly journals Impact of Miniaturization on Early Outcome of Percutaneous Nephrolithotomy

2019 ◽  
Vol 17 (3) ◽  
pp. 320-324
Author(s):  
Mahesh Bahadur Adhikari ◽  
Sumeet Karna ◽  
Kinju Adhikari ◽  
Atul Kasaju ◽  
Jagdish Lal Baidya
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Standard Procedure ◽  
Renal Stones ◽  
P Value ◽  
Complication Rates ◽  
Significant Difference ◽  
Size Standard ◽  
Hemoglobin Drop

Background: Percutaneous nephrolithotomy has become the standard procedure for large renal stones but still remains highly challenging due to complications such as bleeding and sepsis, even though it has high stone free rate (SFR). We report the early outcomes of more than 1000 percutaneous nephrolithotomys done in our center.Methods: A retrospective study of all patients undergoing percutaneous nephrolithotomy from January 2010 to December 2017 in single institution was conducted. All cases were stratified into three groups based on tract size; standard percutaneous nephrolithotomy with tract size ? 22 F, mini percutaneous nephrolithotomy with tract size 15 – 20 F and ultramini percutaneous nephrolithotomy with tract size ? 14 F. Age, gender, stone complexity using Guy’s stone score, stone size, operative time, hemoglobin drop, hospital stay, early major and minor complications were reviewed.Results: A total of 1074 patients had undergone percutaneous nephrolithotomy among which, 578 patients were standard percutaneous nephrolithotomy, 433 mini percutaneous nephrolithotomy and 63 had undergone ultramini percutaneous nephrolithotomy. There was even distribution of patients with Guy’s stone score 1 and 2 in all three groups. However, majority of patients with Guy’s stone score 3 underwent standard percutaneous nephrolithotomy or mini percutaneous nephrolithotomy and no patients with Guy’s stone score 4 underwent ultramini percutaneous nephrolithotomy. Age group, gender and operative time were comparable between the groups; however, significant difference was noted in terms of less hemoglobin drop and shorter hospital stay (p-value < 0.05) in the miniaturized percutaneous nephrolithotomy group. Complications were found to be fewer in mini percutaneous nephrolithotomy and ultramini percutaneous nephrolithotomy group in comparison to standard percutaneous nephrolithotomy.Conclusions: Miniaturization of tract size significantly decreases post-operative complication rates, blood loss and hospital stay while maintaining high stone free rates in well selected patients undergoing Percutaneous nephrolithotomy.Keywords: Endourology; percutaneous nephrolithotomy; PNL; urolithiasis.

Effects of severe hydronephrosis on the outcomes of percutaneous nephrolithotomy with one-shot dilation method

2021 ◽  
pp. 039156032110011
Author(s):  
Uygar Micoogullari ◽  
Cem Yucel ◽  
Tufan Sueluzgen ◽  
Erdem Kisa ◽  
Mehmet Zeynel Keskin ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Percutaneous Nephrolithotomy ◽  
Previous History ◽  
Fluoroscopy Time ◽  
Urinary Tract Abnormality ◽  
Postoperative Blood Transfusion ◽  
Significant Difference ◽  
Operation Duration ◽  
Group 2 ◽  
Group 1

Objective: To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique. Materials and methods: Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate. Results: There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( p = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( p < 0.001). Conclusion: Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.

scholarly journals Outcome of mini percutaneous nephrolithotomy ‘miniPCNL’ in children

2018 ◽  
Vol 5 (2) ◽  
pp. 12-17
Author(s):  
Samir Shrestha ◽  
Pukar Maskey ◽  
Jay N Shah
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Pediatric Population ◽  
Renal Stones ◽  
Safe Procedure ◽  
Gross Hematuria ◽  
Residual Stone ◽  
Stone Clearance ◽  
Conversion To Open Surgery

Introductions: Renal stone disease is one of the common urological disorders with prevalence approximately 2-3% in the general population and the incidence in children is increasing at a rate of 4% per year. Miniaturization of endoscopic instruments, minimally invasive endoscopic procedures of mini percutaneous nephrolithotomy (miniPCNL) in children is increasingly used. This study was conducted to assess the outcome of miniPCNL in pediatric population. Methods: This retrospective study analyzed the outcome of miniPCNL in children below 18 years of age from August 2015 to July 2018 at Patan Hospital, Nepal. Ethical approval was obtained. Outcome was assessed descriptively on stone localization, puncture success, stone clearance, bleeding requiring transfusion, gross hematuria, urosepsis, operative time, hospital stay, mortality and need of second procedures. Results: A total of 26 patients underwent miniPCNL, mean age 10.8±5.45 years (1-18 years), mean operative time was 122±26.03 minutes and mean hospital stay was 3.2±1.12 days.  Postoperative transfusion was required in 1 (2.6%), gross hematuria occurred in 1 (2.6%), no urosepsis, no conversion to open surgery. Complete stone clearance was achieved in 22 (84.61%) patients.  Mortality was nil. Second procedure was required in 4 (15.38%) to achieve residual stone clearance. Conclusions: Our study shows miniPCNL is an effective and safe procedure with minimal morbidity for the treatment of pediatric renal stones.

scholarly journals Percutaneous nephrolithotomy tract dilatation techniques comparison (Balloon vs. Amplatz): Our Experience in Middle East.

2020 ◽  
Author(s):  
Adnan A. Abu-Qamar ◽  
Mohanad M. Al-Naser ◽  
Ashraf S. Al-Majali ◽  
Mohammad A. Al-serhan ◽  
Firas A. Al-Hammouri ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Statistical Evaluation ◽  
Renal Stones ◽  
Invasive Technique ◽  
Transfusion Rate ◽  
Stone Clearance ◽  
Achievement Rate ◽  
Spss Software

Abstract Background: percutaneous nephrolithotomy (PCNL) is a gold widespread minimally invasive technique for the remedy of huge renal stones > 2 cm. Our intention is to review the versions among the Balloon and Amplatz dilatation of percutaneous nephrolithotomy (PCNL) tract exploitation peri- and postoperative variables and make clear which technique is efficient.Methods: 600 sufferers who underwent PCNLs among (1-April 2012 and 20-September 2018) in our Urology Center had been listed all through this retrospective look at, and divided into 2 groups: (group1) balloon tract dilatation (300 sufferers) and (group2) Amplatz serial fascial (ASF) dilatation (300 sufferers). Therefore, the demographic and categorical statistics were compared between each team.Statistical evaluation used: SPSS software version twenty-four, T-test.Results: operative time (balloon vs. Amplatz group: (85 ± 32 vs. 86.5 ± 31) mins; P= zero.073), preoperative Hematocrit value (41.5 ± 8.2 vs. 40.three ± 9.4; P= 0.088), postoperative Hematocrit cost (36.1 ± 2.2 vs. 34.6 ± three.4; P= 0.023), blood transfusion levels (10.6% vs. 12.1%; P= 0.002), tract dilatation trials (20.4% vs. 22.6%; P= 0.051), stone clearance price (78.three% vs. 77.8%; P= 0.083), and therefore, the versions regarding the price have been higher slightly in balloon cluster while within the opportunity variables had been statistically insignificant besides blood transfusion rate and postoperative hospital live.Conclusion: The balloon dilatation is price effective than amplatz method in manner of postoperative hospital live length and blood transfusion, whereas most of the other diverse factors like safety, operative period, achievement rate, and stone clearance price; they gave comparable consequences.

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 Minimally invasive direct coronary artery bypass versus off-pump coronary surgery through sternotomy

2013 ◽  
Vol 95 (7) ◽  
pp. 481-485 ◽  
Author(s):  
R Birla ◽  
P Patel ◽  
G Aresu ◽  
G Asimakopoulos
Keyword(s):  
Coronary Artery ◽  
Blood Transfusion ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Off Pump ◽  
Opcab Group ◽  
Significant Difference ◽  
The Mean

Introduction Although it is not a new technique, minimally invasive direct coronary artery bypass (MIDCAB) is employed only by a few surgeons in the UK. We compared our experience with MIDCAB with that of single vessel off-pump coronary artery bypass (OPCAB) graft surgery through a standard median sternotomy. Methods Patients who underwent either MIDCAB or OPCAB between April 2008 and July 2011 were reviewed. Exclusion criteria included patients with an ejection fraction of <0.5 or previous cardiac surgery. Data were obtained retrospectively from our prospective database, medical records and through general practitioners. Results Overall, 74 patients were analysed in the MIDCAB group and 78 in the OPCAB group. Their demographics and EuroSCORE (European System for Cardiac Operative Risk Evaluation) values were comparable (p>0.05). There was no statistically significant difference in the two groups in terms of mortality, recurrent myocardial infarction, postoperative stroke, wound infection, atrial fibrillation or need for reintervention. The MIDCAB group had six conversions to a sternotomy. Eight patients in each group required blood transfusion, with the average transfusion being 1.8 units in the MIDCAB group and 3.2 units in the OPCAB group. The mean duration of ventilation and intensive care unit stay was 5.0 hours and 38.4 hours in the MIDCAB group and 5.4 and 47.8 hours in the OPCAB group. The mean hospital stay was significantly reduced in the MIDCAB population (6.1 vs 8.5 days, p<0.05). Conclusions MIDCAB can be performed safely in appropriately selected patients with outcomes comparable with OPCAB. The potential benefits include shorter hospital stay, reduced need for blood transfusion and faster recovery.

Sign in / Sign up

Export Citation Format

Share Document