Research progress of percutaneous nephrolithotomy

Wei, Chao; Zhang, Yucong; Pokhrel, Gaurab; Liu, Xiaming; Gan, Jiahua; Yu, Xiao; Ye, Zhangqun; Wang, Shaogang

doi:10.1007/s11255-018-1847-4

Cited by 18 publications

(16 citation statements)

References 124 publications

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“…Compared with open and laparoscopic surgery, PCNL has the advantages of less trauma, high stone removal efficiency, mild postoperative pain, less bleeding, and quick recovery. It has now become a common surgical method for the treatment of upper urinary tract stones (12). However, compared with other minimally invasive stone surgery techniques, PCNL is still the most invasive surgical method, and systemic inflammatory infection is one of the most common complications after PCNL.…”

Section: Discussionmentioning

confidence: 99%

Predictive Model for Systemic Infection After Percutaneous Nephrolithotomy and Related Factors Analysis

Tang

Zhang

et al. 2021

Front. Surg.

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Objectives: To investigate the factors associated with systemic infection after percutaneous nephrolithotomy (PCNL) and establish a predictive model to provide theoretical basis for the prevention of systemic inflammatory response syndrome (SIRS) and urosepsis correlate to percutaneous nephrostomy.Methods: Patients received PCNL between January 2016 and December 2020 were retrospectively enrolled. All patients were categorized into groups according to postoperative SIRS and urosepsis status. Single factor analysis and multivariate logistic regression analysis were performed to determine the predictive factors of SIRS and urosepsis after PCNL. The nomograms were generated using the predictors respectively and the discriminative ability of was assessed by analyses of receiver operating characteristic curves (ROC curves).Results: A total of 758 PCNL patients were enrolled in this study, including 97 (12.8%) patients with SIRS and 42 (5.5%) patients with urosepsis. Multivariate logistic regression analysis suggested that there were 5 factors related to SIRS, followed by preoperative neutrophil to lymphocyte ratio (NLR) (odds ratio, OR = 1.721, 95% confidence interval, CI [1.116–2.653], p = 0.014), S.T.O.N.E. score (OR = 1.902, 95% CI [1.473–2.457], p < 0.001), female gender (OR = 2.545, 95% CI [1.563–4.144], p < 0.001), diabetes history (OR = 1.987, 95% CI [1.051–3.755], p = 0.035), positive urine culture (OR = 3.184, 95% CI [1.697–5.974], p < 0.001). And there were four factors related to urosepsis, followed by preoperative NLR (OR = 1.604, 95% CI [1.135–2.266], p = 0.007), S.T.O.N.E. score (OR = 1.455, 95% CI [1.064–1.988], p = 0.019), female gender (OR = 2.08, 95% CI [1.063–4.07], p = 0.032), positive urine culture (OR = 2.827, 95% CI [1.266–6.313], p = 0.011). A nomogram prediction model was established to calculate the cumulative probability of SIRS and urosepsis after PCNL and displayed favorable fitting by Hosmer–Lemeshow test (p = 0.953, p = 0.872). The area under the ROC curve was 0.784 (SIRS) and 0.772 (urosepsis) respectively.Conclusion: Higher preoperative NLR, higher S.T.O.N.E. score, female gender, and positive urine culture are the most significant predictors of SIRS and urosepsis. Diabetes history is the predictor of SIRS. These data will help identify high-risk individuals and facilitate early detection of SIRS and urosepsis post-PCNL.

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Section: Discussionmentioning

confidence: 99%

Predictive Model for Systemic Infection After Percutaneous Nephrolithotomy and Related Factors Analysis

Tang

Zhang

et al. 2021

Front. Surg.

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“…The length of hospitalization is a new investigation era for PCNL. The technology continues to improve, and postoperative complications are decreasing, ''outpatient'' procedure is an option now for highly selected patients (9). However, we still routinely admitted patients to follow-up.…”

Section: Discussionmentioning

confidence: 99%

Papillary vs non-papillary access during percutaneous nephrolithotomy: Retrospective, match-paired case-control study

Tahra

Sobay

Bindayı³

et al. 2020

Arch Ital Urol Androl

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Objective: The most crucial steps of percutaneous nephrolithotomy (PCNL) are the percutaneous access and dilation of the access route. Recent literature suggests that papillary access to renal calyx is the accepted method. Despite this rule, we do not always make papillary puncture and we puncture wherever we can to achieve stone-free status and reduce unnecessary access. In this study, we present our results with papillary vs non-papillary access in patients with a kidney stone. Material and methods: Two hundred and seven patients with non-papillary access and 69 patients with papillary access who had similar demographics (age, body mass index (BMI), stone size) were selected with pair match analysis (3:1). Preoperative and postoperative data were collected from the patient's chart. Operative time (from starting surgery to nephrostomy tube), drop-in hematocrit level, transfusion rate, duration of hospital stay, perioperative and postoperative complications (Clavien-Dindo Classification) and stone-free status (no or < 3 mm residual stone) were also evaluated in both groups. Results: The mean operative time was similar in between two groups. The mean hematocrit decreases not differ between the two groups (p = 0.56). In papillary group, only 2 patients (3.2%) required transfusion and only one patient (1.4%) in the non-papillary group had a transfusion with no statistically significant difference (p = 0.43). The overall complication rates were 7.1% in the papillary group and 7.2% in the non-papillary group (p = 0.89). Postoperative mean creatinine level was similar between the two groups. Conclusions: In this study, we found that non-papillary access is a feasible option for PCNL in the terms of stone-free status and complication rates.

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“…However supine PCNL offers the potential advantages of less patient handling, only draping the patient once, and easier access to the urethra, allows better airway management and may be less hazardous, especially for morbid obesity, and preferrd by anesthesiologists. There is better drainage with the Amplatz sheath, and stone fragment evacuation is facilitated [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

Homouda

Elbahnasy

Omar

2022

JAMMR

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Aims: To compare between supine and prone percutaneous nephrolithotomy (PCNL) in the management of renal stones regarding stone free rate, operative time and fluoroscopy time. Methodology: A retrospective analysis was performed in the period between January 2019 and January 2021 for patients underwent PCNL for renal stones 2 cm or more. They were 77 patients divided into two groups, group (A) prone 38 patients and group (B) supine 39 patients. Results: the study demonstrated a significant difference in operation time which was (92.5 ± 24.85 min.) in prone group & (68.3 ± 22.90 min.) in supine group with p-value (<0.001), also significant difference in fluoroscopy time which was (258.0 ± 57.19 sec.) in prone group & (166.9 ± 46.60 sec.) in supine group with p-value (<0.001) with shorter operation and fluoroscopy time in the supine than the prone. The study has also demonstrated that there is no statistically significant difference between the two groups as regarding to stone free rate. Conclusion: in patients with renal stones, 2 cm or more, supine PCNL has proved to be superior to prone PCNL as regarding operative and fluoroscopy time but no difference as regards stone free rate. However, Urologists should be familiar with the differences in the positions and be able to use the method appropriate for each patient.

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Research progress of percutaneous nephrolithotomy

Cited by 18 publications

References 124 publications

Predictive Model for Systemic Infection After Percutaneous Nephrolithotomy and Related Factors Analysis

Predictive Model for Systemic Infection After Percutaneous Nephrolithotomy and Related Factors Analysis

Papillary vs non-papillary access during percutaneous nephrolithotomy: Retrospective, match-paired case-control study

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

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