Micropercutaneous nephrolithotripsy: initial experience

Olcucuoglu, Erkan; Kasap, Yusuf; Ölçücüoğlu, Esin; Şirin, Mehmet Emin; Gazel, Eymen; Taştemur, Sedat; Odabaş, Öner

doi:10.5114/wiitm.2015.54223

Cited by 4 publications

(8 citation statements)

References 44 publications

(48 reference statements)

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“…Ölçücüoğlu et al. 14 found that the curative effect of an F4.8 visual puncture system in combination with holmium laser lithotrity was effective for the treatment of calculi <2 cm, and that the wound size was reduced and the success rate of channel establishment improved. Silay et al.…”

Section: Discussionmentioning

confidence: 99%

Treatment of renal calculi without hydronephrosis using a standard channel assisted by a visual puncture system

Wang

Cui

Zhu³

et al. 2020

J Int Med Res

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To study the safety and efficacy of standard channel establishment using a visual puncture system in the treatment of renal calculi without hydronephrosis. Methods: We retrospectively analyzed data from 46 patients undergoing percutaneous nephrolithotomy via a standard channel assisted by a visual puncture system, including number of punctures, duration of procedure, hemoglobin level after surgery, calculi clearance rate, and postoperative complications. Results: Sixty-nine channels were established, including a single channel in 26 cases, double channel in 17 cases, and three channels in 3 cases. The mean number of punctures was 1.50, mean time to establish the standard channel was 2.6 minutes, and duration of surgery was 31.3 minutes. No significant change in hemoglobin was observed after surgery. Forty-three patients had no residual calculi and three had small residual calculi on the day after surgery, representing a first-phase clearance rate of 93.48% (43/46). No significant complications were observed. Conclusions: Hemorrhage during operation can be significantly reduced by establishing a standard channel using a visual puncture system. Moreover, the number of standard channels can be reduced and the incidence of complications lowered using this approach, which should be adopted widely for the treatment of renal calculi without hydronephrosis.

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Section: Discussionmentioning

confidence: 99%

Treatment of renal calculi without hydronephrosis using a standard channel assisted by a visual puncture system

Wang

Cui

Zhu³

et al. 2020

J Int Med Res

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“…Non-enhancing CT was used to evaluate patients at 1-month and 3-month follow-up. Clinically insignificant residual fragments (CIRFs) were defined as asymptomatic non-obstructing residual fragments <4 mm on CT. 2,7,12…”

Section: Postoperative Evaluationmentioning

confidence: 99%

“…PCNL has a high stone-free rate (SFR), however, one of its major complications is hemorrhage, which is associated with the size of the percutaneous renal tract. [1][2][3][4] Efforts to decrease complications have focused on instrument size. Thus, less invasive and more refined instruments have been developed, such as those used during mini-PCNL and ultramini-PCNL.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, less invasive and more refined instruments have been developed, such as those used during mini-PCNL and ultramini-PCNL. [2][3][4][5][6] Bader et al 3 established percutaneous renal tracts using a 16-gauge optical puncture system in 2011. Desai et al 7 first reported on the puncture and disintegration of urinary stones in a single step without tract dilation and named this innovative PCNL "microperc. "…”

Section: Introductionmentioning

confidence: 99%

“…5,8,13,14 Second, similar to extracorporeal shock wave lithotripsy (ESWL) and flexible ureteroscopy, PCNL is a "break and leave" process with stone fragments left to discharge spontaneously after the surgery. 2,[6][7][8]10,14 However, fragment discharge may be difficult, such as in patients with an abnormal lower calyx and anatomy. 6,7,10,[19][20][21] Furthermore, residual stone fragments can cause renal colic and postoperative steinstrasse.…”

Section: Introductionmentioning

confidence: 99%

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Microperc with Self-Assembled Fr 4.85 Visual Needle and Ureteral Access Sheath

Zhang

Kang

Jiang

et al. 2021

Journal of Investigative Surgery

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Background: Micropercutaneous nephrolithotomy (microperc) is the least invasive among percutaneous nephrolithotripsy (PCNL) procedures. Although microperc has a high stone-free rate and certain advantages over other methods, modifications may be needed to improve the technique. We describe our experience performing microperc using a self-assembled visual needle and ureteral access sheath (UAS). Methods: Between June 2016 and April 2019, the data of 30 patients with kidney stones undergoing microperc with our self-assembled 4.8 Fr visual needle combined with a UAS was retrospectively analyzed. Patients were placed in an obilique spine lithotomy position. Results: Two cases were excluded: one due to conversion to mini PCNL and the other required flexible ureteroscopy during microperc. The remaining 28 cases included 18 men and 10 women, age 38.4 ± 7.5 years, stone size 1.7 ± 0.4 cm, and stone density on CT 969 ± 233 HU. Operative time was 47 ± 9.9 minutes, visual analogue scale score of tract pain on postoperative day 1 was 2.5 ± 1.0, hemoglobin decrease was 6.4 ± 1.0 g/L, and hospital stay was 3.1 ± 0.8 days. There was 1 case of fever and urinary infection, 2 cases of hematuria, and 1 case of flank pain. All symptoms resolved after conservative or antibiotic treatment. On postoperative day 1, 12 (42.9%) caseswere stone-free. The stone-free rates at postoperative month 1 and 3 were 92.9% (26/28) and 100% (28/28), respectively. Conclusions: Our self-assembled visual needle and UAS instrument is effective for microperc. Use of the UAS may improve the operative outcome.

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Role of Minimally Invasive (Micro and Ultra-mini) PCNL for Adult Urinary Stone Disease in the Modern Era: Evidence from a Systematic Review

et al. 2018

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Purpose of ReviewThe role of PCNL and the expertise surrounding it has expanded in recent decades. Miniaturisation of equipment and instrument size has formed a part of this innovation. Although an increasing number of studies have been performed on miniaturised PCNL (Mi-PCNL) recently, a critical appraisal on these is lacking. We therefore conducted a systematic review of the literature to evaluate the efficacy, safety and feasibility of Mi-PCNL techniques (< 15 Fr).Recent FindingsA systematic review was conducted from 1990 to March 2017 on outcomes of Mi-PCNL [micro PCNL (m-PCNL) and ultra-mini PCNL (UMP)] in adult patients. Ten studies (three on m-PCNL and seven on UMP) were included in our study. Across the three studies, 118 patients (mean age 42.2 years, male to female ratio 1.3:1) underwent m-PCNL (4.8 Fr). For a mean stone size of 13.9 mm, a mean stone-free rate (SFR) was 89% and an overall complication rate was 15.2% [Clavien classification I (44%), II (28%), III (28%)], with no Clavien IV or V complications. Across the seven studies, 262 patients (mean age 49.4 years, male to female ratio 1.5:1) underwent UMP (13–14 Fr). For a mean stone size of 18.6 mm, a mean SFR was 88.3% and an overall complication rate was 6.2% [Clavien classification I (57%), II (36%), III (7%)], with no Clavien IV or V complications. While the transfusion rates for m-PCNL was 0.85%, only one case each in m-PCNL and UMP needed conversion to mini PCNL.SummaryOur review shows that for small- to medium-sized renal stones, Mi-PCNL can yield good stone-free rates whilst maintaining a low morbidity associated with it. There were no Clavien > III complications and no mortality with only one transfusion reported from this minimally invasive technique.

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Micropercutaneous nephrolithotripsy: initial experience

Cited by 4 publications

References 44 publications

Treatment of renal calculi without hydronephrosis using a standard channel assisted by a visual puncture system

Treatment of renal calculi without hydronephrosis using a standard channel assisted by a visual puncture system

Microperc with Self-Assembled Fr 4.85 Visual Needle and Ureteral Access Sheath

Role of Minimally Invasive (Micro and Ultra-mini) PCNL for Adult Urinary Stone Disease in the Modern Era: Evidence from a Systematic Review

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