Percutaneous nephrolithotomy (PCNL) a critical review

Ganpule, Arvind; Vijayakumar, M.; Malpani, Ankur; Desai, Mahesh

doi:10.1016/j.ijsu.2016.11.028

Cited by 117 publications

(80 citation statements)

References 15 publications

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“…65,66 Size of tract Currently, there are at least two nomenclature for PCNL tract size, which might lead to confusion (Table 2). 67,68 Although the stone clearance rate is good with the standard PCNL, mini-PCNL has been shown to have less blood loss, reduced hospital stay and more tubeless procedures without compromising the stone clearance rate or increasing the infective complications. [69][70][71][72] However, there are controversies on whether procedure time is prolonged.…”

Section: Dilatation Of Tractmentioning

confidence: 99%

Updates in endourological management of urolithiasis

Teoh

2018

Int J of Urology

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Urinary stone disease, or urolithiasis, is a very common disease with increasing prevalence and incidence. With the advancement of endoscopic techniques, the treatment outcomes of ureteroscopy (or transureteral lithotripsy) and percutaneous nephrolithotomy are continuously improving. In recent years, there have been many new developments in the field, including new endoscopy design, more effective auxiliary tools, improvement in treatment protocols, introduction of robotic technology, combining both ureteroscopy and percutaneous nephrolithotomy (endoscopic combined intrarenal surgery or transureteral lithotripsy‐assisted percutaneous nephrolithotomy), improvement in laser technology, and so on. All these new inputs will further improve the treatment efficacy and safety of the procedures, thus benefiting our patients. In the present review, we briefly go through the main steps of ureteroscopy and percutaneous nephrolithotomy, with a concise description and application of these new advances.

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Section: Dilatation Of Tractmentioning

confidence: 99%

Updates in endourological management of urolithiasis

Teoh

2018

Int J of Urology

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“…Различные исследования показали, что при ко-ралловидном нефролитиазе ХБП распространена намного больше и имеет более серьезные послед-ствия, чем считалось ранее [8]. Кроме того, опе-ративное лечение коралловидных камней более травматично и связано с более высокими рисками развития осложнений и повторного камнеобразо-вания [2,10]. Все вышеуказанное говорит о том, что одним из важнейших этапов лечения МКБ яв-ляется метафилактика -мероприятия, направлен-ные на снижение вероятности развития рецидивов камнеобразования.…”

Section: вве дениеunclassified

Staghorn stones’ composition analysis features

et al. 2017

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The lack of standards in the analysis of the chemical composition of the staghorn stones leads to a decrease in the effectiveness of metaphylaxis, and especially in those cases where the volume of the stone is much larger than the volume of the stone fragment being studied. The aim of this study was to develop standards in order to determine the composition of the staghorn calculi. In the Institute of urology from 2015 to 2016, we identified patients with urolithiasis, staghorn-stone nephrolithiasis who were eventually hospitalized. All patients underwent percutaneous nephrolithotripsy, and fragments of the stone were taken in order to analyze its chemical composition. An analysis of the composition of various fragments taken from different zones of the same calculus was made. Patients were divided into 4 groups depending on the composition of the stone. The first group included patients with a predominance of phosphate in the internal layer of the pelvic fragment of the stone, the second group – with a predominance of oxalates, the third – with a predominance of urates, the fourth – with cystine stones. Our experience, while doing stone analysis, showed that the composition did not coincide in 77% of cases, and in 41,6% of cases a new component in the chemical composition of the stone appeared. Complete coincidence of the composition in the cortical and internal layer of the stone was detected in 35% of the cases, and component coincidence in 58% of cases. In the cortical and internal layers of the pelvic fragments, the total and component coincidence of the composition was 38% and 58%, respectively. Thus, we show the importance of chemical analysis of stones and that the composition of the stone may vary, depending on its location. Timely detection of changes in the nature of the stone allows an adequate treatment of urolithiasis.

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“…Percutaneous nephrolithotomy (PCNL), first reported by Fernstrom and Johansson [1], has gradually become a preferred therapy modality for the management of large and complex urinary stones in the last 2 decades [2][3][4]. Additionally, PNCL can be used in patients with failed extracorporeal shockwave lithotripsy and ureteral endoscopy [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy Under Regional versus General Anesthesia: A Meta-Analysis of Randomized Controlled Trials

et al. 2018

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The aim of the present meta-analysis was to systematically examine the literature and to identify of the results of randomized controlled trials (RCTs) comparing the efficacy and safety of regional anesthesia (RA) versus general anesthesia (GA) for percutaneous nephrolithotomy (PCNL). An exhaustive electronic literature search of PubMed, Embase, and Web of science was performed until March 2018. Nine prospective RCTs concluding 858 patients comparing the use of RA to GA for PCNL were included. Combined results demonstrated that PCNL under RA could reduce operative time (mean difference [MD] -6.20; 95% CI -10.39 to -2.01), hospital stay (MD -0.59; 95% CI -0.74 to -0.45), visual analgesic score on the first and third postoperative day (MD -2.62, 95% CI -3.04 to -2.19 and MD -0.38; 95% CI -0.58 to -0.18) , analgesic requirements (MD -36.84; 95% CI -55.23 to -18.45), and nausea and/or vomiting (relative risk [RR] 0.28; 95% CI 0.13-0.61). There were no significant differences between RA and GA groups in terms of stone-free rate, blood transfusion, and postoperative fever rate. The results of subgroup analysis were basically consistent with the overall findings. Current evidence suggests that RA is an available and safe option in carefully evaluated and selected patients.

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Percutaneous nephrolithotomy (PCNL) a critical review

Cited by 117 publications

References 15 publications

Updates in endourological management of urolithiasis

Updates in endourological management of urolithiasis

Staghorn stones’ composition analysis features

Comparison of Percutaneous Nephrolithotomy Under Regional versus General Anesthesia: A Meta-Analysis of Randomized Controlled Trials

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