The Acceptable Criterion of Stone Burden and the Significant Factors to Choose Retrograde Intrarenal Stone Surgery or Miniaturized Percutaneous Nephrolithotomy for the Treatment of Renal Stones >10 mm

2017 ◽  
Vol 31 (10) ◽  
pp. 1012-1018 ◽  
Author(s):  
Juhyun Park ◽  
Sohee Oh ◽  
Min Chul Cho ◽  
Hwancheol Son ◽  
Hyeon Jeong ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Stone Burden ◽  
Significant Factors

scholarly journals Evaluation and Comparison of Predictive Efficiency of S.T.O.N.E. and CROES Nephrolithometry Scoring Systems in Percutaneous Nephrolithotomy

2020 ◽  
Author(s):  
Erhan Ateş
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Scoring System ◽  
Operation Time ◽  
Hounsfield Unit ◽  
Scoring Systems ◽  
Renal Stones ◽  
Stone Burden ◽  
Preoperative Ct ◽  
The Mean ◽  
Free Status

INTRODUCTION: Currently, there is no consensus on an ideal predictive model that characterizes the complexity of renal stones and predicts surgical results after percutaneous nephrolithotomy (PCNL). The aim of this study is to compare the accuracy of the S.T.O.N.E.nefrolithometry scoring system and CROES nephrolithometric nomogram in predicting stone-free rate and complications of PCNL results. METHODS: Data from 50 renal units (45 patients) who underwent PCNL operation by the same surgeon between March 2016 and January 2019 for > 2 cm kidney stones were retrospectively analyzed. Preoperative clinical and radiological data and postoperative features of the patients were recorded. Postoperative complications were classified according to the modified Clavien scoring system. S.TO.N.E. and CROES nephrolithometry scores were calculated on preoperative CT images for each patient, and their relationship with stone-free status and complications was evaluated by logistic regression analysis. RESULTS: The mean stone burden was 778.6 ± 665.4 mm2, the mean Hounsfield Unit was 990.6 ± 335.1 HU, the mean operation time was 125 ± 34 minutes, the mean hospitalization time was 4.7 ± 2.71 days. The mean S.T.O.N.E score was 8.76 ± 2.03, and the mean CROES score was 134.26 ± 67.36. Complete stone-free was achieved in 21 (42%) of the cases. In cases with residual stones, the stone burden was statistically significantly higher compared to cases without stone-free (p = 0,000). There is a positive correlation between the S.T.O.N.E. score and the operation time (r = 0.487, p = 0.000). But, there was a negative correlation between the operation time with the CROES score (r = -0.514, p = 0.000) and the nephrostomy time (r = -0.29, p = 0.04). The relationship between both scoring systems and stone-free rates were statistically significant (p = 0,000). There was a statistically significant relationship between the presence of complications and only the CROES scoring system (p = 0.032). DISCUSSION AND CONCLUSION: S.T.O.N.E. and CROES scoring systems have predictive value for stone-free status after PCNL. The CROES nephrolithometry nomogram is more effective in predicting complications after PCNL.

scholarly journals Initial Experience of Percutaneous Nephrolithotomy at Lumbini Medical College

2013 ◽  
Vol 1 (1) ◽  
pp. 35
Author(s):  
Prakash Sapkota ◽  
Y B Tambey ◽  
Sunil Thapa ◽  
Rajan Shakya
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Renal Stones ◽  
Invasive Approach ◽  
Medical College ◽  
Stone Burden ◽  
Estimated Blood Loss ◽  
The Mean

  Introduction: Renal stone disease is a challenging problem in urologic practice especially in our locality because of large stone burden and recurrence. Since ,the early 1980s when percutaneous nephrolithotomy (PCNL) was established for management of renal stones, open surgical procedures have virtually been replaced. PCNL is a safe, effective and minimally invasive approach compared to open surgery for patients with large single, multiple or staghorn stones. The aim of this prospective study was to evaluate and to review our experience with PCNL in management of renal and upper ureteric stones.   Methods: Prospective study carried out at Lumbini Medical College and Teaching Hospital during 1stJanuary 2011 to 31st October 2011. Sixty patients were evaluated and subjected to PCNL. After clinical investigations like ultrasonography (USG) and intravenous urography (IVU), once patients were found to have renal or upper ureteric stones they were informed and explained about PCNL, its likely complications, probable hospital stay, the cost of treatment and data were recorded along with the operative time, estimated blood loss, stone burden, stone-free rate, length of hospitalization and complications .Patients were followed up after three months to rule out recurrence of stones by plain abdominal x-ray of kidney, ureter and bladder and USG.   Results: Out of 60 patients 35 were male and 25 were female (M: F=1.4:1) with mean age of 37 years and were subjected to PCNL monotherapy. With the average stone size of 3.26cm, the mean operative time was 78 minutes. Complete stone removal achieved by PCNL alone in 60 cases, with insignificant residual small stones we achieved 97% stone clearance rate. The mean hospital stay was 3.7 days. No Serious complications were encountered, 9 (15%) patients required blood transfusion and 3 (5%) patients developed transient post-operative pyrexia.   Conclusion: PCNL is the first line treatment option for management of large renal stones which as monotherapy has advantages in removal of renal and upper ureteric stones and achieving excellent results with minimal morbidity.

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 Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

Complications and surgical results of stone-directed antegrade pyelography compared to the retrograde pyelographic access method in percutaneous nephrolithotomy using ‘bull’s eye’ technique: A randomized clinical trial

2021 ◽  
pp. 205141582199372
Author(s):  
Dariush Irani ◽  
Abdolreza Haghpanah ◽  
Mohammad Mehdi Hosseini ◽  
Leila Malekmakan ◽  
Mohammad Ali Ashraf ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Surgical Results ◽  
Retrograde Pyelography ◽  
Antegrade Approach ◽  
Antegrade Pyelography ◽  
Significant Difference ◽  
Bull's Eye

Objectives: This study aimed to evaluate the differences in outcomes and complications in stone-directed antegrade pyelography using the ‘bull’s eye’ technique in patients with renal stones versus the conventional method of percutaneous nephrolithotomy (PCNL). Although conventional PCNL access using retrograde pyelography is useful, it is time-consuming and may cause postoperative discomfort. Herein, we report our experience in the application of this new technique. Methods: Between January 2017 and June 2018, 100 patients participated in this randomized clinical trial. Stone-directed antegrade pyelography using the ‘bull’s eye’ technique under fluoroscopic guidance was used for percutaneous access in the intervention group. The second group, consisting of those who had undergone conventional PCNL using retrograde pyelography and ‘bull’s eye’ technique in the same period, were considered as the controls. Pre- and postoperative laboratory examinations, surgical results and complications were recorded and compared between the two groups. Results: A single calyceal puncture in partial staghorn and staghorn stone patients was sufficient in 72.2% of the antegrade group and in 78.9% of the retrograde group ( p=0.69). The double-puncture technique was necessary for 71.9% of renal pelvis stones in the antegrade group and for 9.4% in the retrograde group ( p<0.001). The antegrade approach reduced the mean operative time and analgesic requirement significantly ( p<0.001). No statistically significant difference, however, was found between the two groups regarding stone migration to the ureter, radiation time and postoperative complications. Conclusions: The stone-directed antegrade approach using the ‘bull’s eye’ technique is a safe and accurate method in PCNL access in patients with radiopaque and semi-opaque renal stones.

Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm

Urolithiasis ◽  
2013 ◽  
Vol 41 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Mustafa Kirac ◽  
Ömer Faruk Bozkurt ◽  
Lutfi Tunc ◽  
Cagri Guneri ◽  
Ali Unsal ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Lower Pole ◽  
Retrograde Intrarenal Surgery
Sign in / Sign up

Export Citation Format

Share Document