Small-caliber percutaneous nephrolithotomy (SC-PCNL). Therapeutic decision algorithm

Sesmero, José Heriberto Amón; Delgado, Manuel; Martín, B. de la Cruz; Rodríguez, J.A. Mainez; Fernández, D. Alonso; Tesedo, Verónica Rodríguez; Way, D.A. Martín; Aceves, Jorge

doi:10.1016/j.acuroe.2017.08.001

Cited by 2 publications

(2 citation statements)

References 93 publications

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“…The summarized flow chart for treatment algorithm is shown in Figure 3. 166,[174][175][176][177][178][179][180][181]184,185,188,189,[191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206]. What is an algorithm for treatment of adult patients with ureteral stones?…”

Section: Commentarymentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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Section: Commentarymentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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“…Radiation exposure during PCNL is another concern still discussed [10]. Over time, the safety and efficacy of PCNL have improved through various changes and modifications [11]. The introduction of flexible URS and its combination with PCNL (ECIRS) has aided in the most complex cases and, in many instances, abolished the need for multiple punctures [12].…”

Section: Introductionmentioning

confidence: 99%

Multitract percutaneous nephrolithotomy in the management of staghorn stones

Rashid

Mahmood

Amin³

et al. 2020

Afr J Urol

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Background Staghorn stones are difficult to manage with a risk of significant renal impairment and urosepsis. Percutaneous nephrolithotomy is the first-line treatment for staghorn stones. Often, multiple access tracts are needed to render the patient stone-free. PCNL has been combined with SWL, flexible URS (ECIRS), and mini-PCNL to access residual fragments without the need of additional tracts. However, in a country with limited access to technology and a restraint on resources, multitract PCNL still is the preferred option. The aim of this study was to assess the safety and efficacy of multitract PCNL in such an environment. Methods We analyzed data on sixty-five patients with staghorn calculus who underwent multitract PCNL for a staghorn calculus. Data included demographics, stone parameters, intraoperative parameters, complications and clinical outcomes. Hb-drop and creatinine changes were assessed pre- and post-OP. Complications were graded according to the modified Clavien-Dindo classification. Results In a total of 65 patients [47 males (72%)], 154 percutaneous access tracts were used in 66 renal units. The number of tracts varied between 2 and 4 in a single renal unit. The stone-free rate was 85%. 20% of patients developed grade I, 14% grade II, and 3% grade III b complications. There were no grade IV and V complications. Conclusion Multitract PCNL is safe and efficient, with a good stone-free rate and an acceptable complication rate. When auxiliary combination treatments are not available, multitract standard PCNL remains an option.

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Small-caliber percutaneous nephrolithotomy (SC-PCNL). Therapeutic decision algorithm

Cited by 2 publications

References 93 publications

The Urological Association of Asia clinical guideline for urinary stone disease

The Urological Association of Asia clinical guideline for urinary stone disease

Multitract percutaneous nephrolithotomy in the management of staghorn stones

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