Percutaneous nephrolithotomy through superior calyceal approach - our experience

Introduction: Percutaneous Nephrolithotomy (PCNL) is considered the treatment of choice for large (> 2 cm size) renal stones at present. Aim of this study was to evaluate the results of PCNL as monotherapy in our centre which were done through superior calyceal approach.Materials and Methods: Seventy five patients with three bilateral renal stone (total 78 renal units) that underwent PCNL through superior calyceal approach at Apollo Hospitals Dhaka from May 15, 2005 to December 15, 2007 were included in this retrospective study. Selected patients had renal stones more than 2 cm in size (average stone size 35 mm and surface area 750 mm2). Ultrasonogram, intravenous urogram and in some selected cases CT scan were done to detect the location and size of the stone. Urologist performed percutaneous punctures through superior calyx in prone position under fluoroscopic guidance and general anaesthesia were employed in all cases. Post-operative stone clearance was documented on plain X-ray KUB and ultrasonogram KUB.Results: PCNL was successfully (complete stone clearance and insignificant residue) carried out in 68 patients (69 renal units). Average stone clearance was 88.46%. No second look procedures were needed. Uro-sepsis was the main complication, occurred in 9 renal units (11.53 %) while urinary leakage/ fistula in 6.41%, significant bleeding in 6 renal units (7.69 %) and pleural breach with fluid in pleural cavity (hydrothorax) in 2 (2.6 %) cases. Mean blood transfusion was 1.2 units and mean hospital stay was 67 hours.Conclusion: Monotherapy with PCNL is highly effective in the treatment of large volume renal calculi and staghorn calculi using superior calyceal supracostal and subcostal approach. As a minimally invasive procedure, it is quite safe in experienced hand.Keywords: Percutaneous nephrolithotomy, Renal stone, Superior calyceal puncture, Staghorn calculiDOI: 10.3329/pulse.v3i1.6543Pulse Vol.3(1) July 2009 p4-6

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

African Journal of Urology ◽

10.1186/s12301-019-0002-5 ◽

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.

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The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180927112127 ◽

2020 ◽

Vol 16 (1) ◽

pp. 80-87

Author(s):

Coskun Kaya ◽

Yurdaer Kaynak ◽

Aral Karabag ◽

Aykut Aykaç

Keyword(s):

Predictive Factors ◽

Renal Stones ◽

Renal Calculi ◽

Abdominal Fat ◽

Ureteral Stones ◽

Stone Size ◽

X Ray ◽

Extracorporeal Shock Wave ◽

Stone Density

Background: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate. Methods: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group. Results: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05). Conclusion: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.

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

Bangladesh Medical Journal ◽

10.3329/bmj.v41i3.18954 ◽

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

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Effectiveness and Safety of Percutaneous Nephrolithotomy (PCNL) in Malrotated Kidneys

10.53350/pjmhs211582362 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2362-2365

Author(s):

Sami ur Rehman ◽

Liaqat Ali ◽

Jehanzeb . ◽

Muhammad Asif ◽

Syed Arif ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Technique ◽

Percutaneous Nephrolithotomy ◽

Preoperative Evaluation ◽

Renal Stones ◽

Stone Size ◽

Stone Clearance ◽

Large Size ◽

Group I ◽

Staghorn Stone

Background and Aim: The renal stones of any size could be effectively managed through an essential surgical technique known as Percutaneous Nephrolithotomy (PCNL). The large size renal stones with abnormal kidneys imposed additional challenges for PNCL in anomalous kidneys. The present study aimed to evaluate the effectiveness and safety of Percutaneous Nephrolithotomy in malrotated kidneys. Place and Duration: Conducted at Urology department of Mian Gul Abdulhaq Jehanzeb Kidney Hospital Manglawar, Swat for duration of two years (from May 2019 to April 2021). Materials and Methods. This single-centered retrospective study was conducted on 80 patients who underwent percutaneous nephrolithotomy with malrotation kidneys. The individuals with anomalous kidneys and complex calculi were enrolled in this study. These patients had kidneys anomalies such as horseshoe kidneys, crossed fused ectopia, malrotation kidneys, pelvic and complete stone clearance. Posterior or anterior approaches were followed for the procedure after preoperative evaluation in kidney anomalies. Retrograde catheterization was carried out under spinal and general anesthesia with the patients. For all the patients, stone size and clearance were measured. Results: Of the total 80 kidneys anomalies patients, 55 (68.7%) were male and 25 (31.3%) were females. Overall mean age was 35.26 ± 13.51. The stone size varied from 1.3cm to 7 cm. Patients were categorized into two groups based on stone sizes such as group I (1.3-2.5 cm) had 42 (52.5%) and group II (25-7cm) 38 (47.5%) patients. The patients included renal pelvis 19 (23.6%), the pelvic ureteric junction (PUJ) 8 (10%), horseshoe kidneys 2 (2.5%), crossed fused ectopia 9 (11.3%), and malrotation kidneys 3 (3.8%).The stone clearance was completed in 77 (96.3%) patients. The statistically significant factor for complete clearance was the staghorn stone calculus. Conclusion: Percutaneous nephrolithotomy is a safe and effective procedure for large renal stones management in patients of anomalous kidneys. Higher renal stones clearance can be achieved with minimum morbidity by suitable preoperative evaluation and technical experts. Keywords: Malrotated kidney; Nephrostomy, Percutaneous; Nephrolithiasis; Abnormality

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Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

Advances in Urology ◽

10.1155/2014/423730 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Abdul Rouf Khawaja ◽

Tanveer Iqbal Dar ◽

Ajay Kumar Sharma ◽

Farzana Bashir ◽

Vipin Kumar Tyagi ◽

...

Keyword(s):

Prospective Study ◽

Percutaneous Nephrolithotomy ◽

Renal Stones ◽

Single Center ◽

Stone Clearance ◽

X Ray ◽

Routine Investigation ◽

Single Center Experience ◽

Second Look ◽

A Prospective Study

Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN) is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients.Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients.Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram.Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

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

Journal of Renal and Hepatic Disorders ◽

10.15586/jrenhep.v5i2.118 ◽

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.

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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 of Percutaneous Nephrolithotomy in the Treatment of Renal Calculi of 10 to 20 MM Size: A Comparison With Extracorporeal Shock Wave Lithotripsy

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49881 ◽

2020 ◽

Vol 21 (2) ◽

pp. 98-104

Author(s):

Muhammad Mahmud Alam ◽

Mohammad Rezaul Karim ◽

Mohammad Ohiduzzaman Khan ◽

Mohammad Mukhlesur Rahman ◽

Mahfuja Asma ◽

...

Keyword(s):

Shock Wave ◽

Percutaneous Nephrolithotomy ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Renal Stones ◽

Renal Calculi ◽

Post Procedure ◽

Extracorporeal Shock Wave ◽

Significant Difference

Background: Stones in the urinary tract is a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) is also widely applied. There is a trend of using ESWL for treatment of renal stones smaller than 1 cm and PCNL in those with stones greater than 2 cm. Nevertheless, no consensus regarding treatment of renal stones between 1 to 2 cm stones. The objective of this prospective study was to compare the results of ESWL and PCNL for treatment of 1 to 2 cm renal stones. Method : This is a quasi experimental study. This study was conducted to compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) in treating 10 to 20 mm sized renal stone among the Bangladeshi population. This prospective study conducted between the periods of September, 2011 to August, 2012 in the department of urology, Bangabandhu Sheikh Mujib medical university (BSMMU) Hospital. All the patients attending the urology outpatient clinic with 10 to 20mm renal calculi were the study population. A total of 70 subjects were enrolled for this study and they were equally divided into two groups so that each group had 35 subjects. The one group received PCNL whereas the other group received ESWL. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-15). Results: There is no statistically significant difference in regarding age, sex, stone side(lt. or rt.), the distribution of stone (upper, middle and lower calyx) and size between the groups (p>0.05). At 3 month follow up among the patients in ESWL group stone cleared and not cleared were 25(71.4%) and 10(28.6%) respectively and at 3 month follow up among the patients in PCNL group stone cleared and not cleared were 33(94.3%) and 2(5.7%)respectively. There is statistically significant difference in stone clearance rate at 3 month follow up between the groups (p<0.05). All patients in ESWL group developed post procedure haematuria 35(100.0%). Other post procedure complications among the ESWL group pain, fever and steinstrasse were 12(34.3%), 07(20.0%) and 03(08.6%) respectively. Common post procedure complications among the patients of PCNL group pain, haematuria and fever were 11(31.4%), 33(94.3%) and 13(37.1%) respectively. Other post procedure complications in PCNL group were vomiting (8.6%), urinary leakage (5.7%), wound infection (11.4%) and urinary cutaneous fistula (5.7%). There was no statistically significant difference post procedure pain, haematuria and fever between the groups (p>0.05), but statistically significant difference observed in steinstrasse and wound infection between the groups (p<0.05). Mean±SD of hospital stay among the patients of ESWL group and PCNL group was 1.37±0.65 and 4.34±1.43 days respectively. There is statistically significant difference in hospital stay between the groups (p<0.05). Conclusion: Though some specific complications which can be treated conservatively are more in PCNL group it may be concluded that the treatment with PCNL is better option than ESWL among the patients having renal calculi 10 to 20 mm. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.98-104

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Variation of Fluoroscopic Radiation Dose during Endourological Procedures for Renal Stones

Nepalese Medical Journal ◽

10.3126/nmj.v3i1.29370 ◽

2020 ◽

Vol 3 (1) ◽

pp. 272-275

Author(s):

Prakash Chhettri ◽

Robin Bahadur Basnet ◽

Anil Shrestha ◽

Parash Mani Shrestha

Keyword(s):

Radiation Dose ◽

Percutaneous Nephrolithotomy ◽

Prospective Observational Study ◽

Renal Stones ◽

Retrograde Intrarenal Surgery ◽

Stone Size ◽

Ureteral Access Sheath ◽

Pelvicalyceal System ◽

Ureteric Catheter ◽

Fluoroscopic Time

Introduction: Fluoroscopic guidance is routine for endourological procedures like percutaneous nephrolithotomy and retrograde intrarenal surgery in vast majority of centers. It is used for the initial retrograde ureteral access to define the pelvicalyceal system, puncture of the desired calyx and dilatation of the tract, aid navigation of stones and calyces, and placement of guide wires and stents. Both the patient and operating staffs are exposed to the radiation during surgery. The purpose of this study is to measure that exposed fluoroscopic radiation dose during these procedures and make operating surgeons aware of their fluoroscopic habit. Materials and Methods: This is prospective observational study, who underwent percutaneous nephrolithotomy (n=60) and retrograde intrarenal surgery (n=43) in our institute between December 2017 and August 2018. Percutaneous nephrolithotomy was done in prone position with prior insertion of ureteric catheter. Retrograde intrarenal surgery was carried out with or without insertion of ureteral access sheath. Fluoroscopic time was taken from the insertion of the ureteric catheter or UAS to the completion of the procedure with double J stenting. Results: For percutaneous nephrolithotomy and retrograde intrarenal surgery group, mean stone size were 21.89 mm and 10.56 mm; mean fluoroscopic time were 117.95 s (range 24-350) and 31.83 s (range 3-103); mean fluoroscopic dose were 29.71 mGy and 6.19 mGy respectively. Introduction: Fluoroscopic guidance is routine for endourological procedures like percutaneous nephrolithotomy and retrograde intrarenal surgery in vast majority of centers. It is used for the initial retrograde ureteral access to define the pelvicalyceal system, puncture of the desired calyx and dilatation of the tract, aid navigation of stones and calyces, and placement of guide wires and stents. Both the patient and operating staffs are exposed to the radiation during surgery. The purpose of this study is to measure that exposed fluoroscopic radiation dose during these procedures and make operating surgeons aware of their fluoroscopic habit. Materials and Methods: This is prospective observational study, who underwent percutaneous nephrolithotomy (n=60) and retrograde intrarenal surgery (n=43) in our institute between December 2017 and August 2018. Percutaneous nephrolithotomy was done in prone position with prior insertion of ureteric catheter. Retrograde intrarenal surgery was carried out with or without insertion of ureteral access sheath. Fluoroscopic time was taken from the insertion of the ureteric catheter or UAS to the completion of the procedure with double J stenting. Results: For percutaneous nephrolithotomy and retrograde intrarenal surgery group, mean stone size were 21.89 mm and 10.56 mm; mean fluoroscopic time were 117.95 s (range 24-350) and 31.83 s (range 3-103); mean fluoroscopic dose were 29.71 mGy and 6.19 mGy respectively. Conclusions: Among the endourological procedures for renal stones, retrograde intrarenal surgery was associated with less fluoroscopic hazard than percutaneous nephrolithotomy. Awareness of fluoroscopic exposure duration and experience of a surgeon can minimize the radiation hazard during endourological procedures.

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Outcomes of Retrograde Intra-Renal Surgery

Nepalese Medical Journal ◽

10.3126/nmj.v2i2.26478 ◽

2019 ◽

Vol 2 (2) ◽

pp. 220-223 ◽

Cited By ~ 1

Author(s):

Samir Shrestha ◽

Pukar Maskey

Keyword(s):

Postoperative Pain ◽

Hospital Stay ◽

Renal Stone ◽

Operative Time ◽

Renal Calculi ◽

Renal Surgery ◽

Surgical Morbidity ◽

Retrograde Intrarenal Surgery ◽

Stone Clearance ◽

The Mean

Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.

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