Kidney displacement does not alter the success and complication rates, but is associated with longer fluoroscopy times during supine PCNL. In the current study, parameters in preoperative non-contrast computerized tomography (NCCT) associated with kidney displacement were identified. We recommend surgeons evaluate and take into account these parameters during preoperative planning to establish better outcomes and diminish fluoroscopy times.
Objectives
In this study, it is aimed to identify the rate of successful placement of a guidewire down through the ureter during PNL and to compare the outcomes of different locations of guidewires in the collecting system following renal puncture in terms of success and complications rates.
Patients and methods
Data of 1052 patients who underwent miniPNL in our institution between January 2014 and November 2020 were analysed. Patients were divided into three groups. Group I consisted of patients with the guidewire coiled within the punctured calyx, group II consisted of patients with the guidewire reaching the renal pelvis and group III consisted of patients with the guidewire passed down through the ureter. The groups were compared for successful tract creation and complication rates.
Results
There were 303 (28.8%) patients in group I, 330 (31.4%) patients in group II and 419 (39.8%) patients in group III. Successful tract dilation at the first attempt was established in 298 (94.7%) patients in group I, 328 (99.4%) patients in group II and in all of the 419 (100%) patients in group III. Successful tract creation was established in a second attempt in all of the patients failed in the first attempt. The groups were similar for stone‐free and complication rates.
Conclusions
Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.