Minimally invasive percutaneous nephrolithotomy guided by ultrasonography to treat upper urinary tract calculi complicated with severe spinal deformity

He, Zhisong; Zhang, Caixia; Zeng, Guohua

doi:10.1590/s1677-5538.ibju.2015.0408

Cited by 6 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, albumin is the common protein in plasma, which can reflect the condition of liver function and body immunity at a certain extent [ 20 ], and once the liver function was impaired, albumin levels were also reduced; meanwhile, there were obstacles in coagulation function and body immunity. Thirdly, urinary abnormal anatomy, large size stones, and complex location stones will increase the difficulties of fragmenting and discharging of stones [ 21 , 22 ]. Lastly, the longer operation time and wound exposure time will increase the risk of bacterial infections and the volume of bleeding, and these risk factors mentioned above were influenced each other and increased the probability of complications, and made an interactive effect to deteriorate the safety profiles on patients [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Application of Clavien–Dindo Classification System for Complications of Minimally Invasive Percutaneous Nephrolithotomy

Zhang

Zhu

2021

Journal of Healthcare Engineering

View full text Add to dashboard Cite

Objective. To investigate the clinical applications of the Clavien–Dindo classification system (CDCS) in the assessment of perioperative complications in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods. Totally, 390 patients with renal stones in our hospital from March 2015 to March 2020 were included for this study and then were divided into observation group (complication group, 78 cases) and control group (noncomplication group, 312 cases) according to the incidence of perioperative complications in CDCS. Single factor analysis and multivariate logistic regression analysis were used to analyze the risk factors of the perioperative complications of MPCNL. Results. The total incidence of complication in the 390 cases with MPCNL was 20.00% (78 cases) according to CDCS, among which the incidence of complications at grades I, II, III, IV, and V was 6.92% (27 cases), 8.21% (32 cases), 2.82% (11 cases), 1.79% (7 cases), and 0.26% (1 case), respectively. The proportion of patients, that aged >60 years, complicated with comorbidities, sophisticated calculi, the preoperative albumin level (<35 g/L), the operation time (>180 minutes), intraoperative bleeding volume (>300 mL), and hospitalization time (>7 days) in the observation group was significantly higher than that in the control group ((75.64% vs. 61.86%, 38.46% vs. 24.36%, 83.33% vs. 69.55%, 83.33% vs. 69.55%, 70.51% vs. 30.76%, 53.85% vs. 36.54%, and 60.26% vs. 43.27%), all P < 0.05). Multivariate logistic regression analysis showed that gender, associated comorbidities, preoperative albumin level, calculus complexity, operation time, and intraoperative bleeding volume (>300 mL) were correlated with the occurrence of complications ( P ≤ 0.001, 0.001, 0.001, 0.001, 0.003, and 0.001 respectively). Conclusion. The CDCS can give standard and more comparative criteria for the assessment of perioperative complications, which will provide reference data for reducing complications and ensuring safety profiles in these high-risk patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Application of Clavien–Dindo Classification System for Complications of Minimally Invasive Percutaneous Nephrolithotomy

Zhang

Zhu

2021

Journal of Healthcare Engineering

View full text Add to dashboard Cite

show abstract

“…The expansion channel used in the microchannel was an F14-18, and a ureteroscope was used instead of the nephroscope to allow for the full flexibility of the ureteroscope. Due to the small diameter of the scope, it can enter the renal pelvis and calyces through the fistula, especially for partial renal calyx stenosis, and can pass smoothly[ 9 , 10 ]. Microchannel percutaneous nephrolithotomy uses ultrasound guidance to observe the structure of the puncture channel in real time and distinguish the collection system, the renal calyx, and the location of kidney stones, which helps the physician grasp the position of the puncture needle, the puncture angle and the depth and avoid the puncture.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the minimally invasive percutaneous nephrolithotomy treatment of upper urinary calculi

Xu¹,

Zhang²,

Li³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Upper urinary tract stones are very common in my country, with an incidence of 1% to 5% in the North and an even higher incidence of 5% to 10% in the south. The incidence rate in the south is higher than that in the north, mainly due to the water quality, climate and eating habits of the region. From the perspective of sex, incidence is more likely in males than females. In the high-incidence population, young adults are most prone to stones. Men in the age range of 25 to 40 years are more likely to have stones. AIM To observe the therapeutic effect of minimally invasive percutaneous nephrolithotomy (mPCNL) on upper urinary tract stones and its influence on the renal function of patients. METHODS Patients with upper urinary tract stones who were treated in our hospital from February 2017 to March 2018 were selected as research subjects and were divided into the PCNL group and the mPCNL group according to the random number table method. The general conditions of the two groups of patients were observed during the perioperative period, and the differences in stone clearance, pain, renal function indicators and complication rates were compared between the two groups to determine which were statistically significant ( P < 0.05). RESULTS The operation time of the mPCNL group was longer than that of the PCNL group ( t = -34.392, P < 0.001), and the intraoperative blood loss of the mPCNL group was more than that of the PCNL group ( t = 34.090, P < 0.001). There was no difference in renal function indices between the two groups of patients before treatment, and there was no difference in the levels of serum creatinine, β2 microglobulin or retinol binding protein in the mPCNL group after treatment. The visual analog scale score of patients in the mPCNL group was lower than that of the PCNL group ( t = 12.191, P < 0.001), and there was no significant difference in the stone clearance rate between the two groups ( χ 2 value = 1.013, P = 0.314). There was no significant difference in the incidence of urine extravasation, dyspnea and peripheral organ damage between the two groups ( χ 2 value = 1.053, P = 0.305). At 1 mo after treatment and 3 mo after treatment, the quality of life of the mPCNL group was lower than that of the PCNL group, and the Qmax level of the mPCNL group was higher than that of the PCNL group. CONCLUSION mPCNL has a good therapeutic effect on upper urinary tract stones, with a high stone clearance rate without causing kidney damage or increasing the incidence of complications, and thus has good application value.

show abstract

“…Patients with spinal deformity can have an increased risk of urogenital malformation and UTI, which increases the risk of urinary stone disease, with a reported incidence rate of up to 20% . Stones from patients with spinal abnormality primarily consist of carbonate apatite and struvite, which probably indicates the result of chronic UTIs.…”

Section: Discussionmentioning

confidence: 99%

“…Management of upper urinary tract calculi complicated with severe spinal deformity remains a challenge. There are, however, few reports in the literature in relation to PCNL in patients with spinal deformity . Although shockwave lithotripsy (SWL) is well tolerated in these patients, the stone‐free rate is poor and further interventional treatment may need to be offered .…”

Section: Introductionmentioning

confidence: 99%

Ultrasound‐guided percutaneous nephrolithotomy for upper urinary tract calculi in patients with spinal deformity: a decade's experience

et al. 2018

View full text Add to dashboard Cite

ObjectivesTo evaluate the efficacy and safety of ultrasound (US)-guided percutaneous nephrolithotomy (PCNL) in managing upper urinary tract calculi in patients with spinal deformity based on our experience over the last decade. Patients and MethodsA retrospective study was conducted on patients with spinal deformity who were admitted to Beijing Tsinghua Changgung Hospital and collaborative hospitals from August 2004 to August 2017. Patients diagnosed with urolithiasis and who underwent US-guided PCNL, performed by the same surgeon, were included. Patients' data were collected and the following variables were analysed: age; sex; plain abdominal radiograph of the kidneys, ureters and bladder (KUB); computed tomography (CT); stone burden; evaluation of spinal anatomy; respiratory function; operative time; and postoperative findings. The severity of surgical complications was determined according to the modified Clavien classification system (MCCS). ResultsA total of 72 patients (41 males and 31 females) were included, with a mean (range) age of 35 (21-69) years. The mean (range) stone diameter was 38 (19-68) mm. Seven patients had bilateral PCNL, completed in staged surgery with a 1-week interval. Five kidneys received staged PCNL because of either large residual stones or the potential risk of a long operation time. In all, 19 patients underwent the surgery in a prone position, 29 lateral, nine oblique supine, and the other 27 in unconventional positions (lateral prone, lateral supine, and lateral jackknife position). All procedures were successfully completed with no major complications during the operation. The mean (SD) tract building time was 8.5 (1.7) min. The mean (SD) stone disintegration time was 39.3 (14.6) min. The mean (range) temperature and postoperative haemoglobin (Hb) drop on the first postoperative day were 37.6 (36.7-39.2)°C and 1.5 (0.2-4.3) g/dL, respectively. Four patients needed blood transfusions and none of the patients had septic shock or severe renal bleeding requiring angiographic renal embolisation or nephrectomy. A stone-free status was achieved in 71 kidneys (89.87%). Eight patients with residual fragments ≥4 mm were either observed without treatment during follow-up or re-treated with shockwave lithotripsy (SWL) according to clinical significance. ConclusionPCNL in patients with spinal deformities is challenging but safe and effective. US-guided puncture and access establishment has its unique advantages when such patients are placed in unconventional positions.

show abstract

Minimally invasive percutaneous nephrolithotomy guided by ultrasonography to treat upper urinary tract calculi complicated with severe spinal deformity

Cited by 6 publications

References 14 publications

Application of Clavien–Dindo Classification System for Complications of Minimally Invasive Percutaneous Nephrolithotomy

Application of Clavien–Dindo Classification System for Complications of Minimally Invasive Percutaneous Nephrolithotomy

Clinical study on the minimally invasive percutaneous nephrolithotomy treatment of upper urinary calculi

Ultrasound‐guided percutaneous nephrolithotomy for upper urinary tract calculi in patients with spinal deformity: a decade's experience

Contact Info

Product

Resources

About