Electrocauterization of bleeding points for percutaneous nephrolithotomy

“…[22][23][24][25][26] In an RCT, Singh and associates 22 studied the absorbable gelatin Spongostan.Ò No benefits could be observed for the gelatin group. 22 In a similar manner, fibrin sealant 23 and SurgicelÒ 24 also failed to improve the outcomes of tubeless PCNL.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Nephrostomy Placement Versus Tubeless Percutaneous Nephrolithotomy

Borges

Fregonesi

Silva

et al. 2010

Journal of Endourology

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Purpose: We performed a systemic review with meta-analysis to compare tubeless vs conventional percutaneous nephrolithotomy (PCNL) and assess the effectiveness and safety of this innovative procedure. Materials and Methods: A systematic review of PUBMED, EMBASE, LILACS, and Cochrane Library was performed to identify all randomized controlled trials (RCTs) that compared tubeless PCNL vs conventional PCNL. The analyzed outcomes were stone-free rate, pain assessment, analgesic medication requirements, operative time, hospitalization time, blood loss, and complications. Results: A total of 10 RCTs were identified that reported 621 patients. Seven studies analyzed stone-free rates. Meta-analysis of the data resulted in no difference between tubeless and conventional PCNL. Operative time, blood transfusion, hemoglobin drop and postoperative fever did not differ between the groups. Meta-analysis of length of hospitalization and prolonged urinary drainage was analyzed and favored the tubeless PCNL group. Conclusions: Tubeless PCNL is a safe and effective procedure with a stone clearance rate comparable to that of conventional PCNL. Tubeless PCNL presented a shorter hospital stay and less postoperative urinary leakage. Pain reduction and minimization of analgesic requirements also were demonstrated.

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“…In 2005, Borin et al [15] used a hemostatic gelatin matrix to provide hemostasis of the access tract for tubeless PCNL. In 2004, we reported our experience of cauterizing the bleeding points during the percutaneous renal surgery and found that this technique could decrease the transfusion rate and enable more patients to become suitable for nephrostomy tube-free modification without increasing complications [6] . With accumulating experience, tubeless PCNL could be achieved even in patients with complicated renal stones.…”

Section: Discussionmentioning

confidence: 99%

“…After complete stone extraction, a 6 or 7 F double J catheter was inserted antegrade through the working channel of the nephroscope. The irrigant was then changed from normal saline to distilled water, while bleeding points were cauterized with a long electrode probe attached to the handpiece of a conventional electric cauterizer [6] . The power for electrocauterization was set at 80 W. The bleeding points were cauterized as the working sheath was withdrawn slowly.…”

Section: Methodsmentioning

confidence: 99%

Tubeless Percutaneous Nephrolithotomy for Geriatric Patients

Jou¹,

Lin²,

Shen³

et al. 2009

Urol Int

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Aim: To evaluate the safety of tubeless percutaneous nephrolithotomy (PCNL) in geriatric patients. Materials and Method: This is a retrospective review of 401 patients who received tubeless PCNL in a single institute. Among these, 50 were performed in patients aged older than 70 years (group 1), while 351 were performed in the remaining younger patients (group 2). Results: There was no significant difference in stone size between the 2 groups (3.6 ± 1.9 vs. 3.5 ± 2.0 cm). The average operative time was similar in both groups (92.8 ± 34.5 vs. 86.6 ± 32.0 min). The stone-free rate in groups 1 and 2 was 68.0% (34/50) and 83.8% (294/351), respectively, which was statistically significantly different. The average postoperative hospital stay was longer in group 1 (4.6 ± 3.4 days) than in group 2 (3.9 ± 2.5 days), but the difference was not statistically significant. There was no significant difference in postoperative urinary tract infection rate and blood transfusion rate in both groups (urinary tract infection: 18.0 vs. 8.8%; blood transfusion: 4 vs. 2.6%). Two patients in group 1 and 3 patients in group 2 experienced pulmonary complications. There was no other severe complication. Conclusion: Tubeless PCNL is a safe procedure for the treatment of geriatric patients with urolithiasis.

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Electrocauterization of bleeding points for percutaneous nephrolithotomy

Cited by 41 publications

References 12 publications

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

Systematic Review and Meta-Analysis of Nephrostomy Placement Versus Tubeless Percutaneous Nephrolithotomy

Tubeless Percutaneous Nephrolithotomy for Geriatric Patients

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