Percutaneous nephrostolithotomy: application to staghorn calculi

Young, A. W.; Hulbert, J C; Cardella, J F; Hunter, Donald; Castańeda-Zúńiga, W R; Reddy, Pratap K.; Amplatz, Kurt

doi:10.2214/ajr.145.6.1265

Cited by 12 publications

(2 citation statements)

References 6 publications

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“…This may be an important issue because some urologists perform as many as three or more (up to six) percutaneous access tracts in one kidney in a singleoperative session. 5,8,[25][26][27][28] In this regard, it is of interest to note that the delivery of a normal clinical lithotripsy dose of 2000 high-energy SWs to pig kidneys resulted in an immediate decline in renal filtration and perfusion that began to recover by 5 hours posttreatment, whereas a greater SW dose of 8000 SWs-which injures a greater amount of renal tissue-led to a similar acute decline in renal function that remained depressed even after 24 hours. 21 Whether a similar scenario occurs as PCNL tract number is increased remains to be investigated, as well as the potential postsurgery implications if the recovery of renal function is indeed delayed.…”

Section: Discussionmentioning

confidence: 99%

Renal Functional Effects of Multiple-Tract Percutaneous Access

Handa

Evan

Willis

et al. 2009

Journal of Endourology

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Section: Discussionmentioning

confidence: 99%

Renal Functional Effects of Multiple-Tract Percutaneous Access

Handa

Evan

Willis

et al. 2009

Journal of Endourology

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“…With the patient under general anesthesia, access to the abscess cavity is maintained using a guidewire, over which the catheter tract is then dilated to 30F using graduated dilators and radiologic guidance. 12 This allows a 30F Amplatz sheath to be inserted. An operating nephroscope that allows intermittent irrigation and suction, with a 4-mm working channel, is then passed along the Amplatz sheath into the abscess cavity.…”

Section: Percutaneous Necrosectomymentioning

confidence: 99%

Percutaneous Necrosectomy and Sinus Tract Endoscopy in the Management of Infected Pancreatic Necrosis: An Initial Experience

Carter¹,

McKay²,

Imrie³

2000

Annals of Surgery

377

286

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ObjectiveTo describe the development of a minimally invasive technique aimed at surgical debridement in addition to simple drainage of the abscess cavity. Summary Background DataSurgical intervention for secondary infection of pancreatic necrosis is associated with a death rate of 25% to 40%. Although percutaneous approaches may drain the abscess, they have often failed in the long term as a result of inability to remove the necrotic material adequately. MethodsFourteen consecutive patients with infected necrosis secondary to acute pancreatitis were studied. The initial four patients underwent sinus tract endoscopy along a drainage tract for secondary sepsis after prior open necrosectomy. This technique was then modified to allow primary debridement for proven sepsis to be carried out percutaneously in a further 10 patients. The techniques and initial results are described. ResultsAdditional surgery for sepsis was successfully avoided in the initial four patients managed by sinus tract endoscopy, and none died. Of the following 10 patients managed by percutaneous necrosectomy, 2 died. The median inpatient stay was 42 days. There was one conversion for intraoperative bleeding. Eight patients recovered and were discharged from the hospital after a median of three percutaneous explorations. Only 40% of patients required intensive care management after surgery. ConclusionsThese initial results in an unselected group of patients are encouraging and show that unlike with percutaneous or endoscopic techniques, both resolution of sepsis and adequate necrosectomy can be achieved. The authors' initial impression of a reduction in postoperative organ dysfunction is particularly interesting; however, the technique requires further evaluation in a larger prospective series.

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Percutaneous Nephrolithotomy

Pietrow¹

Urinary Stone Disease

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Percutaneous nephrostolithotomy: application to staghorn calculi

Cited by 12 publications

References 6 publications

Renal Functional Effects of Multiple-Tract Percutaneous Access

Renal Functional Effects of Multiple-Tract Percutaneous Access

Percutaneous Necrosectomy and Sinus Tract Endoscopy in the Management of Infected Pancreatic Necrosis: An Initial Experience

Percutaneous Nephrolithotomy

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