The Influence of Minimally Invasive Percutaneous Nephrolithotomy on Renal Pelvic Pressure In Vivo

Zeng, Guohua; Zhong, Wen; Li, Xun; Chen, Wenzhong; He, Yongzhong; He, Zhisong; Lei, Ming; Kaijun, Wu

doi:10.1097/sle.0b013e31806e61f4

Cited by 43 publications

(21 citation statements)

References 11 publications

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“…Due to the pressure limit of renal parenchymal reflux is 30 mmHg [6], when the MPCNL is performed under high pressure perfusion it is easy to cause the intrapelvic pressure over 30 mmHg, and the operation manipulation, the integrity of the pelvic wall epithelium could be injured and thereafter leads to direct exposure of venous and lymphatic system followed by renal parenchyma reflux [7]; When the stones and infection occur at the same time, tissue edema and congestion are more likely to cause pelvic fluid absorption. A large amount of short-term liquid absorption can cause the perfusion fluid syndrome, and when the bacteria and its toxin reflux into the blood, complications like bacteremia, sepsis, or postoperative fever occur [8].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery

et al. 2016

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BackgroundCalculus pyonephrosis is difficult to manage. The aim of this study is to explore the value of a patented suctioning sheath assisted minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of calculus pyonephrosis.MethodsOne hundred and eighty two patients with calculus pyonephrosis were randomizely divided into observation group (n = 91) and control group (n = 91). The control group was treated with MPCNL traditionally using peel-away sheath while the observation group was treated with MPCNL using the patented suctioning sheath.ResultsAll the patients in the observation group underwent one stage surgical treatment, 14 patients in the control group underwent first-stage surgery with the rest of the group underwent one stage surgery. The complication rate was 12.1% in the observation group, significantly lower than the rate in the control group which was 51.6%; One surgery stone clearance in the observation group was 96.7% while it was 73.6% in the control group; operative time in the observation group was (54.5 ± 14.5) min, compared to (70.2 ± 11.7) min in the control group; the bleeding amount in the observation group was (126.4 ± 47.2) ml, compared to (321.6 ± 82.5) ml in the control group; the hospitalization duration for the observation group was (6.4 ± 2.3) days, compared to (10.6 ± 3.7) days in the control group. Comparison of the above indicators, the observation group was better than the control group with significant difference (p < 0.001 each).ConclusionsMinimally invasive percutaneous nephrolithotomy with the aid of the patented suctioning sheath in the treatment of calculus pyonephrosis in one surgery is economic, practical, and warrants clinical promotion.Trial registrationThis study was registered with Chinese Clinical Trial Registry on May 18, 2016 (retrospective registration) with a trial registration number of ChiCTR-IOR-16008490.

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Section: Discussionmentioning

confidence: 99%

“…MPCNL surgery complication is related to the amount of liquid absorption. It is a positive correlation between the integrity of the epithelial cells, renal pelvic pressure, and the operation time [6, 9]. Performing MPCNL through irrigation can cause stones shift.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery

et al. 2016

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“…Secondly, in the past, the smaller working tract warned about the elevation of intrarenal pressure, which would induce the risks of bacteremia and sepsis. We once inspected that during mini-PCNL within the 14, 16, and 18 Fr percutaneous tracts, the average renal pelvic pressures were 24.85, 16.23, and 11.68 mmHg, respectively, all lower than the level required for a backflow (30 mmHg) [16]. The fluid in the pelvicalyceal system can be discharged easily.…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

Desai

Zeng

Zhao

et al. 2013

BioMed Research International

137

105

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Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11–13 Fr metal sheath to perform holmium: YAG laser lithotripsy. Methods. The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status. Results. The mean stone size was 14.9 ± 4.1 mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion. Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

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“…Guohua et al. [35] investigated whether such a device contributed to high intrarenal pressures, promoting pyelovenous backflow. They found that the device created intrarenal pressures that were generally lower than the level required for backflow.…”

Section: Nephroscopesmentioning

confidence: 99%

Advances in percutaneous stone surgery

Hartman

Gupta

Leavitt

et al. 2015

Asian Journal of Urology

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Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.

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The Influence of Minimally Invasive Percutaneous Nephrolithotomy on Renal Pelvic Pressure In Vivo

Cited by 43 publications

References 11 publications

A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery

A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery

A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

Advances in percutaneous stone surgery

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