Mp68-13 Outcomes of Patients With Radiographic Xanthogranulomatous Pyelonephritis Managed With Percutaneous Nephrolithotomy

Canvasser, Noah; Lay, Aaron; De, Shuvro; Satyanarayan, Arthi; Kolitz, Elysha; Pearle, Margaret S.; Antonelli, Jodi

doi:10.1016/j.juro.2017.02.2329

Cited by 1 publication

(7 citation statements)

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“…Three studies were excluded, with all three having both unclear mean/median patient age and failure to state number of deaths [12‐14]. Finally, 40 eligible studies were identified, comprising 1139 patients with XGP from 20 nations [3,4,5,6,15–50] (Table 1). All studies were retrospective, and only five were multicentre [20,21,29,37,50].…”

Section: Resultsmentioning

confidence: 99%

“…The presence or absence of XGP‐related mortality was stated by 27 studies, comprising 630 patients [4,6,15–27,29,30,32,34,35,38,40,42,43,45,49,50]. In total there were 18 deaths within 1 year of diagnosis, resulting in a weighted proportion of 1436 deaths per 100 000 patients (95% CI 292–2579; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Slightly more cases occurred in the left kidney (60%) than the right, which was statistically significant (95% CI 52–68%). Four patients had bilateral XGP, all of whom survived [4,40,42]. When stated, the correct preoperative diagnosis of XGP was made in only 183 of 408 patients (45%).…”

Section: Resultsmentioning

confidence: 99%

“…Where reported, upper urinary tract stones were present in 545 of 788 patients (69%) [3,5,6,16–18,20–24,26,27,30,31,33,36,38–44,46,47,49,50]. This included 214 of 450 patients (48%) with staghorn calculi.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies enrolled patients with XGP undergoing nephrectomy via either a laparoscopic or an open approach [3,4,6,18,20,23,27,28,31,32,39,40,46,50]. In this subgroup, most patients received open nephrectomy, while 138 of 405 patients (34%) underwent laparoscopic nephrectomy.…”

Section: Surgical Techniquementioning

confidence: 99%

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Xanthogranulomatous pyelonephritis: a systematic review of treatment and mortality in more than 1000 cases

et al. 2022

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To systematically review the current demographics, treatment and mortality rate associated with xanthogranulomatous pyelonephritis (XGP) and to test the hypothesis that the weighted pooled peri-operative mortality rate will be <10%. MethodsSearches were performed of the Cochrane, Embase and Medline databases and the grey literature for studies published during the period 1 January 2000 to 30 August 2021. Eligible studies reported cohorts of ≥10 predominantly adult patients with XGP and described either average patient age or mortality rate. ResultsIn total, 40 eligible studies were identified, representing 1139 patients with XGP. There were 18 deaths, with a weighted pooled peri-operative mortality rate of 1436 per 100 000 patients. The mean age was 49 years, 70% of patients were female and 28% had diabetes mellitus. The left kidney was more commonly affected (60%). Four patients had bilateral XGP, and all of whom survived. Renal or ureteric stones were present in 69% of patients, including 48% with staghorn calculi. Urine culture was positive in 59% of cases. Fistulae were present in 8%. Correct preoperative diagnosis occurred in only 45% of patients. Standard treatment continues to comprise a short cause of antibiotics and open radical (total) nephrectomy. Preoperative decompression occurred in 56% of patients. When considered at all, laparoscopic nephrectomy was performed in 34% of patients. Partial nephrectomy was conducted in 2% of patients. ConclusionsXanthogranulomatous pyelonephritis has a lower mortality rate than historically reported. A typical patient is a woman in her fifth or sixth decade of life with urolithiasis. While open radical nephrectomy remains the most common treatment method, laparoscopic, and to a lesser degree partial nephrectomy, are feasible in well selected patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%