Totally Ultrasound Versus Fluoroscopically Guided Complete Supine Percutaneous Nephrolithotripsy: A First Report

Falahatkar, Siavash; Neiroomand, Hassan; Enshaei, Ahmad; Kazemzadeh, Majid; Allahkhah, Aliakbar; Jalili, Michael Fariad

doi:10.1089/end.2009.0407

Cited by 45 publications

(30 citation statements)

References 12 publications

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“…Type I and II cases had calculi in the upper ureteral, UPJ, or pelvic calculi combined with middle/severe hydronephrosis. The calculi could be satisfactorily removed with X-ray or B ultrasound by puncturing the renal middle calyx at the 11th intercostal or the subcostal space [10][11][12]. Although this puncture operation is simple, the upper calyx calculi can be easily removed because the channel is established through the lower calyx.…”

Section: Discussionmentioning

confidence: 99%

“…Two or more channels in this type should be established conventionally to complete the operation, thereby resulting in the highest residual rate. The use of an ultrasonic lithotripter (EMS) can significantly improve the efficiency of stone extraction and reduce the residual stones as well as the number of the established channels [10,12,13]. (3) Perfusion pressure should be maintained at the lowest possible rate during operation, and the operation time should be strictly controlled.…”

Section: Discussionmentioning

confidence: 99%

“…Plain abdominal radiograph or CT was repeated after the operation. For cases with more residual calculi, the second or third mini-PCNL was performed 5 to 7 days after the previous operation [10][11][12][13].…”

Section: Operation Proceduresmentioning

confidence: 99%

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Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy

Zeng²,

You

et al. 2014

Indian J Surg

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Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retrocatheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy

Zeng²,

You

et al. 2014

Indian J Surg

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“…21,38,39 Ultrasonography can be an appropriate alternative for fluoroscopy due to suitable outcomes, minimum radiation exposure, proper anatomical identification despite longer access and operative times, and the need for adequate skills or experience. 32,33,[38][39][40] In children, mid-calyceal puncture had a significant effect on complications.21 Shin and colleagues found that a punctured calyx did not predict grade ≥IIIa.6 Aron and colleagues reported similar complication rates for superior and inferior calyceal punctures in complex inferior calyceal stones. 41 In another study, middle and lower calices accesses had similar complication rates and MCC.…”

mentioning

confidence: 99%

“…Different studies demonstrated similar complications between ultrasonography and fluoroscopy, and imaging type had no significant effect on complication rates in children. 21,38,39 Ultrasonography can be an appropriate alternative for fluoroscopy due to suitable outcomes, minimum radiation exposure, proper anatomical identification despite longer access and operative times, and the need for adequate skills or experience. 32,33,[38][39][40] In children, mid-calyceal puncture had a significant effect on complications.…”

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confidence: 99%

Factors affecting complications according to the modified Clavien classification in complete supine percutaneous nephrolithotomy

Falahatkar¹,

Moghaddam

Kazemnezhad³

et al. 2015

CUAJ

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Cite as: Can Urol Assoc J 2015;9(1-2):e83-92. http://dx.doi.org/10.5489/cuaj.2248 Published online February 9, 2015. AbstractIntroduction: An increase in percutaneous nephrolithotomy (PCNL) has been accompanied by an increase in complications. We identified the parameters affecting the severity of complications using the modified Clavien classification (MCC). Methods: From 2008 to 2013, 330 patients underwent complete supine PCNL using subcostal access, one-shot dilation, rigid nephroscopy, and pneumatic lithotripsy. We assessed the impact of the following factors on complication severity based on the MCC: age, gender, body mass index, hypertension, diabetes, previous stone surgery and extracorporeal shock wave lithotripsy, preoperative hemoglobin, renal dysfunction (creatinine >1.4 mg/dL), preoperative urinary tract infection, anatomic upper urinary tract abnormality (AUUTA), significant (moderate-severe) hydronephrosis, stonerelated parameters (opacity, number, burden, location, staghorn, complex stones), anesthesia type, kidney side, imaging and calyx for access, tract number, tubeless approach, operative time, postoperative hemoglobin, and hemoglobin drop and stone-free results. Results: The complication rate was 19.7% (MCC: 0=80.3%, I=6.4%, II=11.2%, ≥III=2.1%). On univariate analyses, only the following factors affected MCC: gender, preoperative hemoglobin, AUUTA, significant hydronephrosis, imaging for access, calyx for access, tract number, postoperative hemoglobin, hemoglobin drop and stone-free result. Renal dysfunction was accompanied by higher complications, yet the results were not statistically significant. Multivariate logistic regression analysis demonstrated renal dysfunction, absence of significant hydronephrosis, AUUTA, multiple tracts, lower postoperative hemoglobin, and higher postoperative hemoglobin drop as the significant parameters which affected MCC and predicted higher grades. The paper's limitations include a low number of cases in the higher Clavien grades and some subgroups of variables, and not applying some techniques due to surgeon preference. Interpretation: Many of the complete supine PCNL complications were in the lower Clavien grades and major complications were uncommon. Renal dysfunction, AUUTA, significant hydronephrosis, tract number, postoperative hemoglobin, and hemoglobin drop were the only factors affecting MCC. IntroductionPresently, percutaneous nephrolithotomy (PCNL) is preferred as a safe and effective way to remove large or multiple upper urinary tract calculi. [1][2][3][4][5][6][7] An increase in PCNL has been accompanied by variations in positions, techniques, and instruments, and these may have led to increased complications.1,2,4,5 Following PCNL, 79.5% of patients may experience an uncomplicated postoperative period, 5,8 although there are reports of an early complication rate of 50.8%. 4PCNL complications may occur during puncturing, access, or stone removal. 4 A standardized classification allow us to compare complications among different instruments, te...

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Radiation Safety During Diagnosis and Treatment

Noureldin

Andonian

2018

Smith's Textbook of Endourology

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Totally Ultrasound Versus Fluoroscopically Guided Complete Supine Percutaneous Nephrolithotripsy: A First Report

Cited by 45 publications

References 12 publications

Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy

Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy

Factors affecting complications according to the modified Clavien classification in complete supine percutaneous nephrolithotomy

Radiation Safety During Diagnosis and Treatment

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