A prospective and randomised trial comparing fluoroscopic, total ultrasonographic, and combined guidance for renal access in mini‐percutaneous nephrolithotomy

Zhu, Wei; Li, Jiasheng; Yuan, Jian; Liu, Yongda; Wan, Shaw P.; Liu, Guanzhao; Chen, Wenzhong; Wu, Wenqi; Luo, Jin-Yan; Zhong, Dongliang; Qi, Defeng; Lei, Ming; Zhong, Wen; Zhang, Ze; He, Zhisong; Zhao, Zhijian; Lu, Suilin; Yu-ji, WU; Zeng, Guohua

doi:10.1111/bju.13703

Cited by 64 publications

(43 citation statements)

References 26 publications

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“…The results showed that RIRS provided a lower complication rate than mini-PCNL; however, the difference had no significance. The complications of mini-PCNL are similar to those of PCNL; bleeding, pain, and fever are very common [35–38]. …”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Jiang

Chen

et al. 2017

BioMed Research International

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Minimally invasive percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are both alternatives for PCNL to treat renal calculi. This study is aimed at comparing the stone-free rate (SFR) and other surgery parameters of two approaches for treating upper urinary calculi. We performed this meta-analysis in September 2016 by searching studies about mini-PCNL and RIRS for treating upper urinary calculi in various databases, and RevMan v.5.3 was applied. Three randomized controlled trials and ten nonrandomized trials were included, involving a total of 1317 patients. Meta-analysis showed that mini-PCNL group led to a higher SFR [odds ratio: 1.96; 95% confidence interval: 1.46–2.64; P < 0.00001] but brought a larger postoperative decrease in hemoglobin levels compared with RIRS. RIRS provided a shorter hospital time. There was no significant difference in operation time. Higher postoperative complications were detected in the mini-PCNL, but the difference was not significant. Grade I and III complications did not vary between two procedures, but grade II complications were of lower incidence in RIRS group. In the light of these results, compared with RIRS, mini-PCNL provided significantly higher SFR and efficiency quotient for managing calculi; however, it resulted in higher incidence of postoperative complications, larger hemoglobin drops, and longer hospital stay.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Jiang

Chen

et al. 2017

BioMed Research International

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“…Our hypothesis was a lower rate of postoperative SIRS in the ABP groups than in the zero‐dose group. According to the sample size calculation formula for comparing the different rates between multiple independent samples,

n = 2 λ / {(2 {sin}^{- 1} \sqrt P_{normalmax} - 2 {sin}^{- 1} \sqrt P_{normalmin})}^{2}

. The λ corresponds to the value of 9.63 with α = 0.05, two‐tailed, and a power of 80%.…”

Section: Methodsmentioning

confidence: 99%

Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial

et al. 2019

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ObjectiveTo study the incidence of postoperative systemic inflammatory response syndrome (SIRS) following different antibiotic prophylaxis (ABP) regimens in retrograde intrarenal surgery (RIRS). Patients and MethodsSingle-centre, randomised, controlled trial (August 2014-September 2017) including 426 patients with renal stones with preoperative sterile urine managed by RIRS (ClinicalTrials.gov NCT02304822). Different ciprofloxacinbased ABP regimens were used and included a zero dose, single dose (30 min before surgery) or two doses (first dose at 30 min before RIRS and additional dose within 6 h after RIRS). The incidence of SIRS was compared using intentionto-treat (ITT) and per-protocol (PP) analyses. ResultsEach group enrolled 142 patients. In the ITT analysis, a zero dose of ABP was statistically similar to the two ABP regimes for the incidence of SIRS (9.9% vs single dose 4.9%, P = 0.112; vs two doses 4.2%, P = 0.062). There were also no relevant differences across groups in the PP analysis; no urosepsis was recorded. In subgroup analysis with stratification by stone area, the three regimens all had a low and similar incidence of SIRS for stones of ≤200 mm 2 in the ITT analysis with a sufficient power value (5.4% vs 6.2% vs 3.6%, P = 0.945 vs single dose and P = 0.553 vs two doses). However, there was a greater chance of SIRS in patients who received no ABP with stones of >200 mm 2 (18% vs single dose 4.3%, P = 0.036; vs two doses 5.5%, P = 0.044). Similar trends were seen in the PP analysis. ConclusionsFor patients with preoperative sterile urine, ABP is not strongly recommended in patients with stones of ≤200 mm 2 , but for stones >200 mm 2 single-dose ABP is still required.

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“…The stones were fragmented by pneumatic lithotripsy. The operating time was calculated from the start of the percutaneous puncture to the completion of nephrostomy tube placement . During the operation, stone fragments were collected in a sterile container with saline and ground to powder using sterile grinders.…”

Section: Methodsmentioning

confidence: 99%

Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones

et al. 2018

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A prospective and randomised trial comparing fluoroscopic, total ultrasonographic, and combined guidance for renal access in mini‐percutaneous nephrolithotomy

Abstract: Mini-PCNL under USG is as safe and effective as FG or CG in the treatment of simple kidney stones (S.T.O.N.E. scores 5-6) but with no radiation exposure. FG or CG is more effective for patients with S.T.O.N.E. scores of 7-8, where multiple percutaneous tracts may be necessary.

Cited by 64 publications

References 26 publications

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial

Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones

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