Feasibility and Safety of Ultrasonography Guidance and Flank Position during Percutaneous Nephrolithotomy

Inanloo, Seyed Hassan; Yahyazadeh, Seyed Reza; Rashidi, Saeid; Amini, Erfan; Nowroozi, Mohammad Reza; Ayayti, Mohsen; Jamshidian, Hassan; Nikoobakht, Mohammad Reza; Aghamir, Seyed Mohammad Kazem; Hemmatian, Omid; Momeni, Seyed Ali

doi:10.1016/j.juro.2018.02.074

Cited by 11 publications

(12 citation statements)

References 24 publications

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“…Some urologist introduced ultrasonography to reduce radiation exposure during needle puncture. Recently, completely ultrasonographically guided PCNL (UPCN) has been presented, with acceptable success rate and complication, to eliminate radiation hazard [2–7].…”

Section: Introductionmentioning

confidence: 99%

Amplatz versus Balloon for Tract Dilation in Ultrasonographically Guided Percutaneous Nephrolithotomy: A Randomized Clinical Trial

Pakmanesh

Daneshpajooh

Mirzaei

et al. 2019

BioMed Research International

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Purpose To compare balloon with Amplatz for tract dilation in totally ultrasonographically guided PCNL (UPCN). Methods We randomized 66 patients candidate for sonographically guided PCNL in the flank position in two study groups. In the first group, we used single step Amplatz dilation (AG) technique in which the 28- or 30-French Amplatz dilator is used for tract dilation. In the other group, we dilated the tract using balloon dilator (BG). We compared procedure time, success rate of dilation, and postoperative clinical outcomes and cost between two groups. ResultsThe rate of short dilation was higher in the Amplatz group (57.6%) compared with Balloon group (36.4%) (P=0.08). When using Amplatz for lower pole access, short dilation occurred in 81% of cases compared with 44% in the BG (P=0.02). Overall operation was longer in the AG (80±21 versus 65±20 minutes P=0.02). Stone free rate was 87.9% in the AG compared with 72.7% in the BG (p=0.12). Mean cost of the surgery was 603±85 USD and 718±78 USD in the AG and BG, respectively (P=0.0001). Hemoglobin drop, transfusion rate, renal function alteration, duration of hospitalization, and complication rate based on Clavien classification were similar in both groups. Conclusions AG showed a higher rate of short dilation compared with BG; consequently, overall operating time was significantly longer in the AG whereas BG was significantly more expensive than AG. Bleeding and other complications were similar in two groups. We observed an advantage for balloon dilation over Amplatz when approaching the lower pole calyxes.

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Section: Introductionmentioning

confidence: 99%

Amplatz versus Balloon for Tract Dilation in Ultrasonographically Guided Percutaneous Nephrolithotomy: A Randomized Clinical Trial

Pakmanesh

Daneshpajooh

Mirzaei

et al. 2019

BioMed Research International

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“…Following the use of mesh in incisional hernia repair, the abdominal wall becomes very stiff and fibrous and the intestines can be pulled to the location of the mesh in case of contact with the peritoneum [ 8 ]. Dilatation through the fibrotic area requires increased pressure on the dilators and Amplatz Sheath, which can damage the equipment or lead to loss of access and sudden/uncontrolled advancement of equipment into the kidney region through perforation [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, reoperation may be challenging in the mesh-covered regions due to intense inflammatory reaction and the consequent fibrosis alters the characteristics of abdominal wall [ 2 ]. Presence of scar tissue interferes with appropriate surgical access and the required tract dilatation during percutaneous nephrolithotomy (PNL) [ 3 ]. In these occasions, ultrasound can serve as a guide, visualizing the region, including the scar and fibrotic tissues.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Guided Percutaneous Nephrolithotomy in Mesh-Repaired Incisional Hernia

Inanloo

Nikoobakht

Akhavizadegan

et al. 2021

Advances in Urology

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Objectives. To describe our technique of percutaneous nephrolithotomy (PNL) in patients with mesh-repaired flank incisional hernia. Polypropylene mesh which is used for fascia strengthening in hernia repair elicits intense inflammatory reaction and the consequent fibrosis alters the characteristics of abdominal wall. Thus, prior history of flank hernia repair with mesh may result in percutaneous nephrolithotomy failure. Materials and Methods. Demographic data, renal stones characteristics, and any complication during surgery and follow-up of patients who were treated by PNL during 2011 to 2020 and had mesh in their flank region were collected. Results. Percutaneous nephrolithotomy was performed without any problem in 8 patients with guide of ultrasonography. Conclusion. Based on our experience, ultrasound-guided PNL is feasible and hypothetically superior to fluoroscopy in such circumstances.

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“…The operation procedure and method of PCNL were performed in accordance with the previous literature standards [9][10][11]. The data of gender, age, BMI, history of basic diseases, location of affected kidney, S.T.O.N.E.…”

Section: Pcnl Operation Mode and Clinical Data Collectionmentioning

confidence: 99%

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

Jiang¹,

Jiang²,

et al. 2020

Eur J Clin Microbiol Infect Dis

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The purpose of this study is to explore the risk factors, bacterial species, and drug resistance of acute pyelonephritis (AP) associated with ureteral stent after percutaneous nephrolithotomy (PCNL) and to provide reference for clinical intervention. The clinical data of 415 patients with indwelling ureteral stent after PCNL from December 2016 to May 2019 were analyzed retrospectively. The patients were divided into infection group (n = 54) and non-infection group (n = 361) according to whether patients had AP. Patients’ clinical data, blood and urine bacterial culture, and drug sensitivity were collected and analyzed. The incidence of AP associated with ureteral stent after PCNL was 13.01% and diabetes mellitus (P = 0.001), postoperative stone residue (P = 0.002), urinary leucocytes ≥ 100/HP (P = 0.018), positive urine culture results (P = 0.001), ureteral stent retention time ≥ 8 weeks (P = 0.004), and high S.T.O.N.E. score (P = 0.014) are independent risk factors for it. Escherichia coli (40.54%, 47.82%), Klebsiella pneumoniae (16.21%, 15.21%), Pseudomonas aeruginosa (10.81%, 4.34%), Enterococcus faecalis (21.6%, 19.56%), and epidermis Staphylococci (10.81%, 13.33%) are the main pathogens in blood and urine. The main sensitive drugs of pathogenic bacteria are imipenem, meropenem, tigecycline, piperacillin/tazobactam, ceftazidime, linezolid, teicoplanin, levofloxacin, vancomycin, tigecycline, etc., while levofloxacin, norfloxacin, penicillin G, first, and second-generation cephalosporins showed a strong drug resistance rate (> 70%). This study found that diabetes, postoperative stone residuals, urinary leukocytes ≧ 100 cells/HP, positive urine culture results, ureteral stent indwelling time ≧ 8 weeks, and high S.T.O.N.E. score were independent of AP associated with ureteral stent after PCNL risk factors and Escherichia coli is the main pathogenic bacteria and shows drug resistance.

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Feasibility and Safety of Ultrasonography Guidance and Flank Position during Percutaneous Nephrolithotomy

Cited by 11 publications

References 24 publications

Amplatz versus Balloon for Tract Dilation in Ultrasonographically Guided Percutaneous Nephrolithotomy: A Randomized Clinical Trial

Amplatz versus Balloon for Tract Dilation in Ultrasonographically Guided Percutaneous Nephrolithotomy: A Randomized Clinical Trial

Ultrasound Guided Percutaneous Nephrolithotomy in Mesh-Repaired Incisional Hernia

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

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