A Novel Surgical Technique for Treatment of Renal Stones in Preschool-aged Patients: Initial Experience With Needle-perc

Xiao, Bo; Diao, Xiaolin; Song, Jin Ho; Ji, Chunyu; Zhang, Gang; Su, Boxing; Tang, Yuzhe; Li, Jianxing

doi:10.1016/j.urology.2020.07.055

Cited by 12 publications

(9 citation statements)

References 17 publications

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“…The study pointed out that with the continuous improvement of endoscopic technology, the concept of needle-like nephroscope was developed in clinical practice combined with early ultrasound-assisted puncture needle puncture of parallel calyceal stones and pushing them to the renal pelvis to perform nephroscopic lithotripsy, so as to prevent redilatation and reduce the number of percutaneous renal channels. It can perform direct powdered lithotripsy through laser after successful puncture of the target calyceal calyx without reconstructing the skin renal channel, which can improve the success rate of stone lithotripsy and has a higher safety [ 17 , 18 ]. At the same time, the treatment procedure was assisted by needle nephroscope, and the stones could be rapidly discharged by high-pressure lavage during the implementation of superior lithotripsy, without the influence of ureteral factors, and the stone clearance effect was satisfactory [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Ge¹,

Wang²

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of percutaneous nephrolithotomy combined with needle nephrolithotomy on renal function and incidence of complications in patients with complex renal calculi. Methods. From March 2020 to March 2022, 88 patients with complex renal calculi were enrolled and divided into two groups. Percutaneous nephrolithotomy (PCNL) was performed in the control group, and percutaneous nephrolithotomy combined with needle nephrolithotomy was performed in the study group. Perioperative conditions, renal function parameters such as blood urea nitrogen (BUN), serum creatinine (Scr), and cystatin C (CysC) levels, inflammatory factors such as C-reactive protein (CRP) and procalcitonin (PCT) levels before surgery and 1 day after surgery were determined. The incidence of complications was statistically analyzed between two groups. Results. There was no significant difference in stone clearance rate between the two groups. The operation time and hospital stay in the study group were shorter than those in the control group. The intraoperative blood loss was less than that in the control group. The VAS score was lower than that in the control group. BUN, Scr, and CysC in the study group were not significantly different from those in the control group. CRP and PCT in the two groups at 1 d after surgery were higher than those before surgery, but CRP and PCT in the study group were lower than those in the control group. The incidence of complications in the study group was lower than that in the control group. Conclusion. Percutaneous nephrolithotomy combined with needle nephrolithotomy is effective and safe in the treatment of complex renal calculi.

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Section: Discussionmentioning

confidence: 99%

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Ge¹,

Wang²

2022

Evidence-Based Complementary and Alternative Medicine

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“…In our previous study, we confirmed the usefulness of needle-perc for treating renal caliceal stones size less than 1.5 cm [7]. This technique was also safe and feasible in infants and preschool children according to our former research [8]. We developed a new needle-perc-assisted endoscopic therapy technique, NAES, to treat the complex renal stones.…”

Section: Introductionmentioning

confidence: 63%

Needle-Perc-Assisted Endoscopic Surgery in Treatment with Renal Staghorn Stones: A Prospective Randomized Controlled Study from a Large-Volume Stone Center

Xiao,

Diao,

Zeng

et al. 2023

Urol Int

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Introduction: The goal of this study was to evaluate the efficacy and safety of needle-perc-assisted endoscopic surgery (NAES) in the treatment of staghorn renal stones via a single-center prospective randomized controlled study. Methods: A total of 219 patients with partial or complete staghorn renal stones were prospectively randomized into two groups between January 2020 and April 2022. In group A (n = 112), patients were treated with traditional standard access, multiple if necessary, and in group B (n = 107), only one standard access was made, and needle-perc was assisted to remove the residual stones in the same stage. All procedures were guided under ultrasound totally. Stone size, operating time, blood loss, pain score, complications, and other related characteristics were monitored and analyzed. Results: Procedures were successful in all patients. The baseline characters were similar between the groups. The mean stone size was comparable (4.5 ± 1.4 vs. 4.7 ± 1.7, p = 0.35). The 1-month stone-free status was achieved in 85 patients (75.9%) in group A and 80 (74.8%) patients in group B (p = 0.72). The operation time was shorter in group A than B (75.1 ± 28.1 min vs. 97.2 ± 20.4 min, p = 0.02). A less blood loss (p = 0.01), shorter hospital stay (p = 0.04), lower pain score (p = 0.04), and lower severe complication rates (p = 0.03) were observed in group B. Conclusion: NAES reveals better postoperative recurrence compared with traditional multiple tracts method for treating staghorn renal stones. The stone-free rate was comparable between the two groups.

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“…However, it is more likely to cause complications, such as urothelial injury, hemorrhage, and tissue perforation [7]. Laser lithotripsy is another effective method but is also prone to complications related to heat injury and spontaneous stone [16][17][18]. US lithotripsy with a nephroscopy or ureteroscopy can facilitate the removal of small stone fragments by suction through a hollow probe [7,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy and its initial clinical application

Hong

Wang

et al. 2022

BMC Urol

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Background To assess the outcome of the mini-track, mini-nephroscopy, mini ultrasonic probe percutaneous nephrolithotomy for upper ureteral and kidney stones. Methods We collected data of 53 patients (55 kidney units) who underwent mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy between September 2020 and March 2021. The study included single and upper ureteral stones from 12 kidneys, multiple stones from 28 kidneys, and staghorn stones from 15 kidneys. Results The mean operative duration was 50.6 min, ranging from 15 to 200 min, whereas the mean lithotripsy and stone removal time was 17.2 min (3–45 min). Moreover, the mean postoperative length of stay was 4.0 days (1–7 days). Besides, the stone-free rate (SFR) of discharge was 89.1% (49/55). The mean hemoglobin drop was 15.3 mg/dL, ranging 1–32 mg/dL. Out of the total cases, only 4 of them displayed minor complications. The outcomes of < 40 mm versus ≥ 40 mm calculi were compared by performing subgroup analysis. The results demonstrated a longer operation duration (65.2 vs. 40.2 min), higher complication rate (13.0% vs. 3.3%), and lower SFR in the ≥ 40 mm calculi subgroup. Conclusions In summary, mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy is an effective and safe method to treat patients with upper ureteral and kidney calculi. This is especially significant for the stone size of 20–40 mm, demonstrating excellent SFR and a lower complication rate.

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A Novel Surgical Technique for Treatment of Renal Stones in Preschool-aged Patients: Initial Experience With Needle-perc

Cited by 12 publications

References 17 publications

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Needle-Perc-Assisted Endoscopic Surgery in Treatment with Renal Staghorn Stones: A Prospective Randomized Controlled Study from a Large-Volume Stone Center

Mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy and its initial clinical application

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