scholarly journals CORRELATION BETWEEN S.T.O.N.E NEPHROLITHOMETRY SCORING IN PREDICTING FREE-STONE RATE AFTER PERCUTANEOUS NEPHROLITHOTOMY

2017 ◽  
Vol 24 (1) ◽  
Author(s):  
Karinda triharyu caesari Putri ◽  
Tarmono Djojodimejo ◽  
Fikri Rizaldi ◽  
Sunaryo Hardjowijoto
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Scoring System ◽  
Renal Stones ◽  
Stone Size ◽  
Residual Stone ◽  
Before And After ◽  
Operative Evaluation ◽  
Contrast Ct ◽  
Stone Density ◽  
Outcome Of Surgery

Objective: To investigate free-stone rate after Percutaneous Nephrolithotomy (PNL) using S.T.O.N.E nephrolitometry scoring system, with regards of stone size (S), skin-to-stone distance (T), obstruction degree (O), number of calyx involved (N), and stone density (E) in Non Contrast CT Scan (NCCT). Material & methods: This is an analytic observational study on patients with renal stones undergoing PNL. All patients underwent NCCT before and after PNL; each variables was measured and counted for a total score. Post-operative evaluation was done using NCCT. Results: Thirty patients met inclusion criteria, 19 (63.3%) were stone-free, and 11 (36.7%) were with residual stone. Among the five variables, stone size (p=0.005), number of calyx involved (p=0.002) affected the outcome of surgery, while skin-to-stone distance, obstruction degree, and stone density did not. The overall total score of S.T.O.N.E nephrolithometry is correlated with the outcome of PNL (p=0.001). Conclusion: S.T.O.N.E nephrolithometry is a simple scoring system, while it is also easy to use, and can be used to predict the free-stone rate after PNL.

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 Variation of Fluoroscopic Radiation Dose during Endourological Procedures for Renal Stones

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.

scholarly journals The Evaluation of Risk Factors for Postoperative Infectious Complications after Percutaneous Nephrolithotomy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Tian Yang ◽  
Shenghua Liu ◽  
Jimeng Hu ◽  
Lujia Wang ◽  
Haowen Jiang
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Percutaneous Nephrolithotomy ◽  
Protective Factor ◽  
Clinical Information ◽  
Renal Stones ◽  
Infectious Complications ◽  
Stone Size ◽  
Postoperative Fever ◽  
Detailed Clinical Information

This study was to evaluate the risk factors of infectious complications after percutaneous nephrolithotomy (PCNL) and build a prediction tool for postoperative complications based on the risk factors. A total of 110 male (67.1%) and 54 female (32.9%) patients who underwent PCNL for renal stones between 2010 and 2014 in our institute were included. A detailed clinical information and laboratory results were obtained from patients. Systemic inflammatory response syndrome (SIRS) and postoperative fever were recorded after PCNL surgery. In all, 45 cases (27.4%) developed SIRS and fever was observed in 20 cases (12.2%). In multivariate analysis, stone size (odds ratio, OR = 1.471,p=0.009) and urine white blood cell (WBC) (OR = 1.001,p=0.007) were related to the development of SIRS. Stone size (OR = 1.644,p=0.024), urine WBC (OR = 1.001,p=0.002) and serum albumin (OR = 0.807,p=0.021) were associated with postoperative fever. We concluded that patients with larger stone size and preoperative urinary tract infection might have a higher risk of developing SIRS and fever after operation, while a high-normal level of serum albumin might be the protective factor for postoperative fever.

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

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.

scholarly journals The evaluations of ESWL, RIRS and m-PCNL treatments in kidney stones smaller than two centimeters

2020 ◽  
Vol 7 (4) ◽  
pp. 450-454
Author(s):  
Hüseyin Saygın ◽  
Gökhan Gökce ◽  
Esat Korğalı
Keyword(s):  
Renal Stones ◽  
Renal Calculi ◽  
Minimal Invasive ◽  
Invasive Treatment ◽  
Stone Size ◽  
Scale Scores ◽  
Before And After ◽  
Duration Of Hospitalization ◽  
Vas Scores ◽  
Minimal Invasive Treatment

Objective: The aim of the current study was to compare the outcome of minimal invasive treatment (RIRS, m-PCNL) with the ESWL, Micro-Percutaneous Nephrolithotomy (m-PCNL), and Retrograde intrarenal surgery (RIRS) in patients with renal calculi less than two centimeters in size. Methods: Preoperative renal ureter-bladder (KUB) film and computed tomography (CT) used to imaging stone size and localization in all patients. Ninety consecutive patients were randomized equally to three groups. We evaluated age, gender, stone size, length of hospitalization, stone-free rates, X-ray duration that patients were exposed during the processes, general anesthesia time, Visual Analogue Scale values, Modified Clavien Complication Scale scores after RIRS, mPCNL, and ESWL on renal stones smaller than 2 cm. Results: At the end of the first month, stone-free rate for the lower calyx stones was 33.3% (3 patients out of 10) in ESWL, 83.3% (10 patients out of 12) in RIRS, and 90.9% (10 patients out of 11) in m-PCNL. ESWL's success in the lower-calyx stones was found to be low. Our rates for the stones in renal pelvis, middle, and upper calyx were % 85.7 (18 patients out of 21) in ESWL, % 94.4 (17 patients out of 18) in RIRS and % 94.7 (18 patients out of 19) in m-PCNL. No difference was observed in the duration of hospitalization among patients who underwent RIRS and m-PCNL. The VAS scores in ESWL group were higher than other groups. There were no significant differences for fluoroscopy time between the groups. Decrease in hemoglobin values before and after the procedure were found to be significant in m-PCNL group (p<0.05). Conclusions: We compared three minimal invasive treatments for less than 2 cm renal stones; m-PCNL and RIRS methods were found to be more effective than ESWL, especially aspects of the stone free rates.

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

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

Number of Tracts or Stone Size: Which Influences Outcome of Percutaneous Nephrolithotomy for Staghorn Renal Stones?

2012 ◽  
Vol 89 (1) ◽  
pp. 103-106 ◽  
Author(s):  
Robab Maghsoudi ◽  
Masoud Etemadian ◽  
Pejman Shadpour ◽  
Mohammad Hadi Radfar ◽  
Hadi Ghasemi ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Stone Size

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 Percutaneous nephrolithotomy through superior calyceal approach - our experience

Pulse ◽  
1970 ◽  
Vol 3 (1) ◽  
pp. 4-6
Author(s):  
AU Shaikh ◽  
R Biswas ◽  
NUM Arif ◽  
N Miah ◽  
W Zaman
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Invasive Procedure ◽  
Renal Stones ◽  
Renal Calculi ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Percutaneous Punctures ◽  
Main Complication

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

scholarly journals Comparison of the most popular methods for predicting stonefree rate after percutaneous nephrolithotomy

2017 ◽  
Vol 77 (4) ◽  
Author(s):  
Rodrigo Ugalde-Resano ◽  
Christian Isaac Villeda-Sandoval ◽  
Elisa Kobashi-Sandoval ◽  
José Alejandro Rivera-Ramírez ◽  
Manuel Alexis Vargas-Robles ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Scoring System ◽  
Tertiary Care ◽  
Scoring Systems ◽  
Time Frame ◽  
Predictive Capacity ◽  
Residual Stone ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate

BACKGROUND: The Guy’s stone score, S.T.O.N.E. nephrolithometry, CROES nomogram, and S-ReSC scoring system have recently been externally validated as effective predictors of stone-free rate after percutaneous nephrolithotomy.OBJECTIVE: We describe herein the advantages of identifying the most accurate scale and propose its standardized use.MATERIALS AND METHODS: We analyzed 188 patients that underwent percutaneous nephrolithotomy for kidney stones within the time frame of October 2010 and July 2015 at a tertiary care referral center. Preoperative and postoperative non-contrast computed tomography scans were used in all patients to compare the four scoring systems, using the strict criterion of absolute absence of residual stone as the stone-free rate.RESULTS: The overall stone-free rate was 57.9%. All scoring systems presented a statistically significant stone-free rate (p<0.001). Only the Guy’s stone score had no correlation with postoperative complications. The four scoring systems had similar accuracy, none of them were more predictive for stone-free rate than the other, and there was no significant difference in the areas under the curve between them (p=0.2). In addition, each scale had a correlation with operative time and length of hospital stay.CONCLUSIONS: The four scales analyzed were excellent predictors for stone-free rate. They had similar receiver operating characteristic curves and areas under the curve, with no significant differences between them. However, the Guy’s stone score presented the best predictive capacity and the S-ReSC scoring system was the best method for predicting complications. It is up to the urologic community to decide which evidence-based scale is the most suitable. Meanwhile, the need for a standardized method continues to grow. KEYWORDS: Stone-free rate; Percutaneous nephrolithotomy; CROES; S-ReSC, S.T.O.N.E.; Guy’s stone score

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