42 Percutaneous nephrolithotomy: Experience with 348 cases

Knoll, T.; Heger, Katrin; Haecker, Axel; Osman, Mahmoud M.; Michel, M.S.; Köhrmann, K. U.; Alken, P.

doi:10.1016/s1569-9056(04)90044-9

Cited by 5 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The treatment time is prolonged while the SFR seems to decrease with larger stones. Furthermore, in experienced hands the complications of conventional PCNL are rare [49,52,53] . Lahme et al.…”

Section: Pcnlmentioning

confidence: 99%

Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

Knoll

Buchholz

Wendt‐Nordahl

2012

Arab Journal of Urology

View full text Add to dashboard Cite

ObjectivesTo review previous reports and discuss current trends in extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS). ESWL was recommended as the first-line treatment for small and intermediate-sized stones in the lower pole, while it is the standard treatment for large stones. However, the stone clearance rate after ESWL seems to be lower than that of stones in other locations. This seems to result from a lower rate of fragment passage, due to anatomical factors.MethodsReports on urinary stone disease were reviewed, assessing only publications in peer-reviewed, Medline-listed journals in the English language (publication years 1990–2011).ResultsRecent experience with flexible URS (fURS) for intrarenal stones showed that excellent stone-free rates can be achieved. With increasing experience and technically improved equipment, fURS has become an alternative to ESWL for small and intermediate-sized renal stones. Furthermore, several authors reported successful retrograde treatment for large renal stones, proposing fURS as an alternative to PCNL. However, the major drawbacks are long operating times and commonly, staged procedures, which is why PCNL remains the method of choice for such stones.ConclusionsConsidering the currents trends and evidence, the 2012 update of the European Association of Urology Guidelines on Urolithiasis has upgraded the endourological treatment of kidney stones. Individual factors such as body habitus, renal anatomy, costs and patient preference must be considered.

show abstract

Section: Pcnlmentioning

confidence: 99%

Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

Knoll

Buchholz

Wendt‐Nordahl

2012

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…In unserem eigenen Patientenkollektiv trat seit über 0 Jahren keine Verletzung von Nachbarorganen auf, ebenso war keine einzige Bluttransfusion notwendig [7]. Wir erklä-ren dies neben der großen Erfahrung unserer Klinik mit diesem Behandlungsverfahren vor allem durch die Erreichung eines 7optimalen Zugangswegs zur Niere.…”

Section: Komplikationenunclassified

Perkutane Nephrolithotomie

2005

Self Cite

View full text Add to dashboard Cite

The introduction of percutaneous nephrolithotomy (PNL) marked a turning point in the interventional treatment of nephrolithiasis. For the first time, the minimally invasive removal of larger kidney stones, which had previously required open surgery, became possible. With the increasing use of extracorporeal shock wave lithotripsy (SWL) during the 1980s, PNL lost clinical importance. However, since SWL has revealed its limitations, and both the patients' wishes and economic demand require a fast stone removal, the importance of PNL has risen again. Given the correct indications and performance, PNL is an efficient treatment modality reaching stone free rates of up to 100%. When PNL is performed by an experienced urologist, complications are low and can be managed conservatively in most cases. The most important step in the performance of a PNL is the anatomically correct puncture of the kidney gaining optimal access to the stone. To reach this, a lower calyx is punctured whenever possible, under combined sonographic and fluoroscopic guidance.

show abstract

“…Die Rate an Bluttransfusionen wird in der Literatur mit bis zu 15 % angegeben [41,47]. In unserem Patientenkollektiv war seit mehr als 10 Jahren keine Transfusion erforderlich [48]. Wir erklären dies neben der groûen Erfahrung, die in unserem Zentrum für dieses Verfahren besteht, durch einen optimalen Zugang unter kombinierter ultraschall-und durchleuchtungsgesteuerter Punktion.…”

Section: Perkutane Nephrolithotomieunclassified

Aktuelle Aspekte der Steintherapie

Knoll

Wendt‐Nordahl²,

Trojan³

et al. 2005

Aktuel Urol

Self Cite

View full text Add to dashboard Cite

More than 30 % of all admissions to an urologic clinic are for the treatment of urinary stones. In almost all cases, the treatment is minimally invasive employing extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS) or percutaneous nephrolithotomy (PCNL). Technical advances in endourology and a growing expertise in ESWL led to a decline in ESWL and an increase in endoscopic techniques. In comparison with ESWL, the endoscopic techniques are more invasive but in most cases achieve a stone free state faster. With the introduction of diagnosis related groups (DRG), the economic aspect of stone therapy is gaining in importance. Stone prevention leads to a cost reduction in the health care system, justifying the use of an appropriate stone metaphylaxis. This review article presents the current recommendations for interventional urinary stone therapy and lists the options of conducting both medical and economically rational therapy.

show abstract

42 Percutaneous nephrolithotomy: Experience with 348 cases

Cited by 5 publications

References 0 publications

Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

Perkutane Nephrolithotomie

Aktuelle Aspekte der Steintherapie

Contact Info

Product

Resources

About