OUTCOME ANALYSIS OF PERCUTANEOUS NEPHROLITHOTOMY IN SUPINE POSITION

2021 ◽  
pp. 26-27
Author(s):  
N.Dhinakar Babu ◽  
D.Mohan Kumar
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Operating Time ◽  
Easy Access ◽  
Outcome Analysis ◽  
Complication Rates ◽  
Visceral Injury ◽  
Average Operating Time ◽  
Treat All ◽  
A Prospective Study

Supine PCNL (Percutaneous Nephrolithotomy) is an Alternative to traditional prone positioning. Benets of the supine position include easy access to the airway and Optimization of cardiopulmonary function in patients. This is a prospective study which analyzes the outcome of percutaneous nephrolithotomy in supine position. There were totally 50 patients included in the study. 27 were male and 23 female patients. Mean age was 43 years, ranging from 18 to 70 years. Right side stones seen in 60% of cases ( 30/50). Average stone size was 2.6cm ranging from 1.8 to 6cm. Average operating time were 63.5 minutes and uroscopy 18.9 minutes (5 to 35 minutes). Clearance rate in our study were pretty good with 90% (45 out of 50 cases). Five patients required secondary procedures and ve had complications in form of sepsis and bleeding requiring blood transfusion. There were no visceral injury or srtula. Thus Supine PCNL has several potential advantages with successful technical feasibility and can be used to treat all stone sizes especially very effective in high risk patients for anesthesia. There is no added risk in this technique, and the stone clearance and complication rates are comparable to standard prone PCNL

Outcomes of Flank-Free Modified Supine Percutaneous Nephrolithotomy Based on BMI

2020 ◽  
pp. 1-6
Author(s):  
Esam Desoky ◽  
Khaled M. Abd Elwahab ◽  
Islam M. El-Babouly ◽  
Mohammed M. Seleem
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Normal Weight ◽  
Significant Difference ◽  
Group A ◽  
Morbid Obese ◽  
Group B ◽  
A Prospective Study ◽  
Nonobese Patients ◽  
The Impact

<b><i>Objective:</i></b> To evaluate the impact of body mass index (BMI) on the outcomes of percutaneous nephrolithotomy (PCNL) in the flank-free modified supine position. <b><i>Patients and Methods:</i></b> A prospective study was carried out in the urology department during the period from May 2015 to October 2019 on 464 patients admitted for PCNL. The patients were divided into 4 matched groups according to their BMI: group A, normal weight with 18.5 ≤ BMI &#x3c;25 kg/m<sup>2</sup>; group B, overweight with 25 ≤ BMI &#x3c;30 kg/m<sup>2</sup>; group C, obese with 30 ≤ BMI &#x3c;40 kg/m<sup>2</sup>; and group D, morbid obesity with BMI ≥40 kg/m<sup>2</sup>. All operative data as well as postoperative outcomes are recorded and compared to each other. <b><i>Results:</i></b> The 4 studied groups were matched regarding age. The comorbidities were slightly higher in groups C and D. The operative time and fluoroscopy time were slightly high in obese and morbid obese groups but with no significant difference. The rate of complications either major or minor was comparable in all groups. No significant difference was seen among all groups regarding hemoglobin loss, stone-free rate, hospital stay, and need for auxiliary procedures. <b><i>Conclusions:</i></b> The outcome of PCNL in flank-free modified supine position is not affected by changes in BMI. The procedure can be performed in obese and morbid obese patients safely with results similar to and comparable to nonobese patients.

scholarly journals Prevention of vault prolapse in cases of procedentia using combined vaginal and laparoscopic approach for vault suspension: Agrawal’s technique

2020 ◽  
Vol 10 (1) ◽  
pp. 296
Author(s):  
Priti Agrawal ◽  
Rishi Agrawal ◽  
Jyotirmay Chandrakar
Keyword(s):  
Intraoperative Complications ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Complication Rates ◽  
Vault Prolapse ◽  
Duration Of Surgery ◽  
Vault Suspension ◽  
Average Operating ◽  
Average Operating Time

Background: The objective of the current study was to assess the need of vault suspension after completion of hysterectomy in all cases of procedentia to prevent vault prolapse and to reduce the operating time for sacrocolpopexy using combined vaginal and laparoscopic approach by two surgeons.Methods: A total of 25 women undergoing surgery for procedentia were included. After completion of hysterectomy the need for vault suspension was assessed intraoperatively. In all cases polypropelene mesh was fixed vaginally to the uterosacral and cardinal ligaments. Vaginal vault was closed vaginally. Laparoscopic surgeon did laparoscopic sacrocolpopexy (LSC). Intraoperative and post-operative complications were then evaluated.Results: Our average operating time was 35 minutes for vaginal hysterectomy and 15 minutes for LSC. The shorter duration of surgery was because mesh was fixed vaginally and trackers were used to fix the mesh to sacral promontory. Intraoperative complications like bladder, ureteric, bowel injuries and hemorrhage were nil in our series. Postoperative stay in hospital was uneventful and all cases were discharged on second postoperative day. Conversion rate to laparotomy was nil. All cases have completed follow up for 5 years with 100% subjective and objective improvement.Conclusions: Restoration of vagina to its normal anatomic position remains the most important fact to prevent vault prolapse. Our technique is very easy, less time taking with negligible complication rates.

scholarly journals A study to compare the outcomes of laser myringotomy and conventional incision myringotomy

2020 ◽  
Vol 6 (11) ◽  
pp. 2081
Author(s):  
Shruthi Pudukulangara ◽  
Somanath B. Megalamani ◽  
Ravindra P. Gadag
Keyword(s):  
Diode Laser ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Operating Time ◽  
Disease Recurrence ◽  
Hearing Improvement ◽  
Average Operating ◽  
Average Operating Time ◽  
Group 2 ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcomes of laser myringotomy and incision myringotomy in terms of operating time, patency of opening, hearing improvement, and disease recurrence.</p><p class="abstract"><strong>Methods:</strong> This study is a prospective study done among 35 children and 68 ears. All cases which were diagnosed to have otitis media with effusion were randomly assigned into two groups: group 1 was treated with diode laser myringotomy and group 2 was treated with conventional incision myringotomy without grommet insertion. These patients were followed up at regular intervals and compared in terms of operating time, patency of opening, recurrence of disease and hearing improvement.   </p><p class="abstract"><strong>Results:</strong> Diode laser myringotomy took an average operating time of 6.38 minutes and the patency of opening was maintained for an average of 13.59 days, compared to the average operating time for incision myringotomy of 9 minutes, and the patency of opening being 12.35 days. These differences were statistically significant (p&lt;0.0001 for operating time and p=0.041 for patency of opening). Hearing improvement was also found to be better in laser myringotomy group (p=0.021).  </p><p class="abstract"><strong>Conclusions:</strong> Diode laser myringotomy is an effective, easy and less time-consuming modality than incision myringotomy for the treatment of otitis media with effusion.  </p>

Minor Hepatic Resection Using Heat Coagulative Necrosis

2009 ◽  
Vol 75 (12) ◽  
pp. 1213-1219 ◽  
Author(s):  
Luigi Sandonato ◽  
Calogero Cipolla ◽  
Fabio Fulfaro ◽  
Giuseppe Lo Re ◽  
Federica Latteri ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hepatic Resection ◽  
Postoperative Bleeding ◽  
Operating Time ◽  
Complication Rates ◽  
Coagulative Necrosis ◽  
Hepatic Parenchyma ◽  
Average Operating ◽  
Average Operating Time ◽  
The Mean

Intra- and postoperative bleeding represents an extremely serious and frequent complication of hepatic surgery. In this study, we evaluated the effectiveness of a radiofrequency (RF) device using heat to cause coagulative necrosis of the hepatic parenchyma to control hemostasis in minor hepatic resection. Between December 2005 and November 2007, a study was conducted of 21 patients undergoing 22 hepatic resections with the RF-assisted technique. Sixteen of these were affected by hepatocellular carcinoma and five had liver metastases from colorectal cancer. Intraoperative blood loss, the need for blood transfusion, the complication rates, operating times, and the duration of postoperative hospitalization were evaluated. Four segmentectomies and 18 tumorectomies were performed. The average blood loss was of 15.7 mL (range, 0-40 mL); the average operating time was 25.7 minutes (range, 12-43 minutes); the mean postoperative hospital stay was 8.2 days (range, 3-49 days) with a median of 6.0 days. The authors concluded that the RF-assisted technique can be a useful method not only for reducing blood loss and avoiding blood transfusions, but also for reducing operating time and postoperative hospitalization for minor liver resections.

Supine tubeless PCNL in horseshoe kidney (a series of cases)

2021 ◽  
pp. 039156032110155
Author(s):  
Sandeep Gupta ◽  
Atar Kasim ◽  
Dilip Kumar Pal
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Operative Time ◽  
Operating Time ◽  
Case Series ◽  
Horseshoe Kidney ◽  
Renal Calculi ◽  
Additional Benefit ◽  
Tubeless Pcnl

Objective: Objective of this case series is accurate access to the respective calyx with stone in horseshoe kidney while performing percutaneous nephrolithotmy in supine position. Reducing operative time and anaesthetic morbidity while performing percutaneous nephrolithotomy in horseshoe kidney with nephrolithiasis in supine position. Materials and Methods: Four patient with one having bilateral renal calculi with horshoe kidney were selected randomly. There were no preference for age, gender; size, location and laterality of stone or BMI. All the patients fit into the AUA guideline criteria for management by percutaneous nephrolithotomy. Preoperative, perioperative and follow up data were collected. Results: Four patients with one having bilateral renal calculi underwent supine tubeless PCNL in 1 year in GMSV position. There was no intraoperative, post operative or on follow up complications in any patient. In all the patients stones were cleared completely in single setting. Conclusion: Supine percutaneous nephrolithotomy in horseshoe kidney is an alternative to the standard prone percutaneous nephrolithotomy in the horseshoe kidney. It provides an additional benefit of performing the procedure in a single position, which is known to reduce total operating time, less anaesthesia related complications and less neuromusculoskeletal injury.

scholarly journals A Comparative Study between Universal Eclectic Septoplasty Technique and Cottle

2017 ◽  
Vol 21 (03) ◽  
pp. 281-285 ◽  
Author(s):  
Odim Amaral Neto ◽  
Flavio Mizoguchi ◽  
Renato Freitas ◽  
João Maniglia ◽  
Fábio Maniglia ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Surgical Approach ◽  
Single Case ◽  
Operating Time ◽  
Case Series ◽  
Symptomatic Improvement ◽  
Complication Rates ◽  
Surgical Time ◽  
Symptom Evaluation ◽  
A Prospective Study

Introduction Since the last century surgical correction of nasal septum deviation has been improved. The Universal Eclectic Technique was recently reported and there are still few studies dedicated to address this surgical approach. Objective The objective of this study is to compare the results of septal deviation correction achieved using the Universal Eclectic Technique (UET) with those obtained through Cottle's Technique. Methods This is a prospective study with two consecutive case series totaling 90 patients (40 women and 50 men), aged between 18 and 55 years. We divided patients into two groups according to the surgical approach. Fifty-three patients underwent septoplasty through Universal Eclectic Technique (UET) and thirty-seven patients were submitted to classical Cottle's septoplasty technique. All patients have answered the Nasal Obstruction Symptom Evaluation Scale (NOSE) questionnaire to assess pre and postoperative nasal obstruction. Results Statistical analysis showed a significantly shorter operating time for the UET group. Nasal edema assessment performed seven days after the surgery showed a prevalence of mild edema in UET group and moderate edema in Cottle's technique group. In regard to complication rates, UET presented a single case of septal hematoma while in Cottle's technique group we observed: 02 cases of severe edemas, 01 case of incapacitating headache, and 01 complaint of nasal pain. Conclusion The Universal Eclectic Technique (UET) has proven to be a safe and effective surgical technique with faster symptomatic improvement, low complication rates, and reduced surgical time when compared with classical Cottle's technique.

scholarly journals Evaluation and comparison of S.T.O.N.E. and Guy’s scoring systems for predicting percutaneous nephrolithotomy outcomes in supine position

2022 ◽  
pp. 039156032110376
Author(s):  
Ahmet Arıman ◽  
Erkan Merder ◽  
Erdem Toprak
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Scoring Systems ◽  
Renal Stones ◽  
Complication Rates ◽  
Residual Stone ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Operation Duration ◽  
Free Rate

Background: Percutaneous nephrolithotomy (PCNL) was applied in the prone position until recently. But also, in recent years supine positions was applied in patients with kidney stones. Predicting how much renal stones can be cleared after surgery and possibility of complications is an important question for both surgeons and patients. Therefore different scoring systems are used to evaluate outcomes of PCNL before surgery. Patients and methods: Between 2018 and 2020, 80 patients with renal stone who underwent PCNL in the supine position were evaluated preoperatively by S.T.O.N.E. and Guy’s scoring systems (GSS). The predictions of both scoring systems for stone-free and complication rates in patients who underwent PCNL in the supine position were evaluated. Also, these scoring systems were compared among themselves for reliability. Result: In both scoring systems, there was a statistically significant difference between postoperative stone-free (SF) and residual stone (RS) of patients and in predicting the likelihood of complications in patients. No statistically significant difference was found between the two scoring systems in predicting the stone-free rate. Conclusion: Our findings revealed that S.T.O.N.E. nephrolithometry and Guy’s score systems can be used effectively to predict stone-free rate, complications, and operation duration in supine position PCNL for renal stones.

scholarly journals Evaluation and Comparison of S.T.O.N.E. and GUY's Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes in Supine Position

2021 ◽  
Author(s):  
Ahmet Arıman ◽  
Erkan Merder ◽  
Erdem Toprak
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Scoring Systems ◽  
Renal Stones ◽  
Complication Rates ◽  
Residual Stone ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Operation Duration ◽  
Free Rate

Abstract Percutaneous nephrolithotomy (PCNL) was applied in the prone position. But also, in recent years supine positions was applied in patients with kidney stones. Predicting how much renal stones can be cleared after surgery and possibility of complications is an important question for both surgeons and patients. Therefor different scoring systems are used to predict stone-free and complication rates before surgery. Patients and Methods: Between 2018 and 2920, 80 patients with renal stone who underwent PCNL in the supine position were evaluated preoperatively by S.T.O.N.E. and Guy’s scoring systems. The predictions of both scoring systems for stone-free and complication rates in patients who underwent PCNL in the supine position were evaluated. Also, these scoring systems were compared among themselves for reliability. Result: In both scoring systems, there was a statistically significant difference between postoperative stone-free (SF) and residual stone (RS) patients and in predicting the likelihood of complications in patients. No statistically significant difference was found between the two scoring systems in predicting the stone-free rate. Conclusion: Our findings revealed that S.T.O.N.E. nephrolithometri and Guy’s score systems can be used effectively to predict stone-free rate, complications and operation duration in supine position PCNL for renal stones.

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