Ambulatory Percutaneous Nephrolithotomy: Initial Series

Shahrour, Walid; Andonian, Sero

doi:10.1016/j.urology.2010.08.001

Cited by 49 publications

(53 citation statements)

References 13 publications

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“…Recently, the ability to perform tubeless PCNL as an outpatient procedure has been reported. 11,12 The capacity to routinely complete PCNL as day surgery is highly attractive due to the anticipated healthcare cost savings and the potential reduction in nosocomial infections. Two case series published in 2010, described good outcomes with ambulatory PCNL in carefully selected patients.…”

Section: Discussionmentioning

confidence: 99%

“…Two case series published in 2010, described good outcomes with ambulatory PCNL in carefully selected patients. 11,12 Since then, outpatient management has been performed in more complex patients, including a case report on tubeless PCNL for bilateral staghorn stones. 18 As we continue to shift toward ambulatory surgery in urology, performing outpatient PCNL in a transplanted kidney is an extension of application of the ambulatory approach to increasingly complicated cases.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient.…”

Section: Introductionmentioning

confidence: 85%

“…9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management. 11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient.…”

Section: Introductionmentioning

confidence: 85%

See 3 more Smart Citations

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

McAlpine

Leveridge

Beiko

2015

CUAJ

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Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney. IntroductionPercutaneous nephrolithotomy (PCNL) is an accepted and widely used approach to extract large renal calculi. Since its description in the 1970s, 1 surgical and technological advances have obviated the need for routine nephrostomy tube placement.2-8 Tubeless PCNL, with ureteral stenting, has been shown to decrease patients' analgesic requirements and hospital length of stay.9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management. 11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient. Case reportA 49-year-old female presented to her community hospital with hematuria and lower abdominal pain over the preceding 48 hours. She had received her second cadaveric kidney transplant 6 years previously for end-stage renal disease of unknown etiology. On presentation she was afebrile and hemodynamically stable. Urine was positive for blood, but negative for nitrites or pyuria. Creatinine was 164 μmol/L (estimated glomular filtration rate 29 mL/min/1.73m 2 ), slightly elevated from her baseline of 150 μmol/L. An ultrasound scan showed a large renal stone in the lower pole of the allograft kidney. Intravenous antibiotics were initiated and the patient was transferred to our tertiary care centre.At our institution, a computed tomography scan revealed a 14 × 12 × 11-mm stone located in the renal pelvis (Fig. 1a, Fig. 1b). There was mild hydronephrosis, yet the parenchyma of the graft was preserved. There was no evidence of a urinary tract infection (UTI)/sepsis and the patient's pain responded to oral analgesia. The surgical options were discussed and a decision was made to proceed with the PCNL. Informed consent was obtained and a 1-week course of levofloxacin was prescribed for UTI prophylaxis.On the morning of the procedure, a stress dose of 100 mg intravenous (IV) hydrocortisone was administered. Cefazolin 1 g IV was given prior to induction of general anesthesia. Flexible cystourethroscopy was performed and a 5Fr openended ureteral catheter was passed up the left transplanted ureteral orifice over a 0.035" guidewire. A Foley catheter was placed to straight drainage and the patient was repositioned supine for percutaneous access. Retrograde ureteropyelography outlined the allograft kidney's collecting system, demonstrating renal...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient.…”

Section: Introductionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 85%

See 2 more Smart Citations

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

McAlpine

Leveridge

Beiko

2015

CUAJ

View full text Add to dashboard Cite

show abstract

“…1,[3][4][5][6][7] Recently, tubeless PCNL, on an outpatient basis, has been reported. 8,9 This case report is the first to describe a case of outpatient bilateral tubeless PCNL in a patient with bilateral large staghorn calculi.…”

Section: Introductionmentioning

confidence: 85%

Outpatient bilateral supracostal tubeless percutaneous nephrolithotomy for staghorn calculi

Kokorovic

Wilson

Beiko

2014

CUAJ

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Percutaneous nephrolithotomy (PCNL) is the surgical procedure of choice to treat staghorn calculi. Most centres perform PCNL as the traditional inpatient procedure. However, outpatient PCNL has been successfully attempted and represents a feasible method of reducing hospital costs. We report the case of a 35-year-old female who underwent outpatient simultaneous PCNL for bilateral renal staghorn calculi. The patient was discharged in stable condition less than 3 hours following the procedure with minimal discomfort. To the best of our knowledge, this case report is the first to describe a successfully completed outpatient bilateral supracostal tubeless PCNL for staghorn calculi.

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