Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

Atmoko, Widi; Birowo, Ponco; Rasyid, Nur

doi:10.12688/f1000research.9509.1

Cited by 8 publications

(3 citation statements)

References 39 publications

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“…F1000Research: Dataset 1. Raw data for Table 1 , Table 2 , and Table 3 of 'Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years’, 10.5256/f1000research.9509.d134117 42 …”

Section: Data Availabilitymentioning

confidence: 99%

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

2016

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Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery ( = 0.01), stone burden ( = < 0.001), and type of anesthesia ( = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; 0.00] were significant independent risk factors for stone-free.

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Section: Data Availabilitymentioning

confidence: 99%

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

2016

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“…Other similar studies also reported similar results, where SFR after standard PCNL seemed to be lower in patients with a higher BMI. 32,33 However, the effect of BMI on PCNL outcomes remains debatable, as several studies by Ferreira et al, 34 Alyami et al, 35 and Akbulut et al 36 showed that PCNL outcomes were independent of BMI. Thus, a large population-based study or randomized controlled trial is needed to ascertain the effect of BMI on PCNL outcomes, especially in the more recent mini-PCNL group.…”

Section: Discussionmentioning

confidence: 99%

Standard versus mini amplatz size in patients undergoing pediatric percutaneous nephrolithotomy through 16 years of experience: A retrospective study in single-center experience

Rasyid,

Fadhly,

Atmoko

et al. 2024

F1000Res

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Background: Pediatric urolithiasis is associated with considerable morbidity and a very high recurrence rate of approximately 67%. Current guideline recommendations for standard pediatric percutaneous nephrolithotomy (PCNL) remain a problem due to several complications, such as hemorrhage or renal damage, especially in the pediatric population. However, mini-PCNL is regarded as a safer and more effective method for pediatric patients. This study compares PCNL with mini-PCNL, along with their efficacy and safety, in the Cipto Mangunkusumo General Hospital, Indonesia. Methods: This observational retrospective study was performed on pediatric patients aged < 18 years (pediatric patients) who underwent PCNL with a standard 22-30 Fr sheath or mini 15-21 Fr sheath. We reviewed postoperative outcomes, including stone-free rate (SFR), presence of complications, and postoperative drainage method. Data analysis was performed using SPSS version 26.0. Results: Our study included a total of 42 pediatric patients (mean age: standard, 4.61 ± 3.52 years; mini, 8.0 ± 3.57 years; p<0.05). The stone-free rate was significantly higher in the mini-PCNL group (87.9%) than in the standard PCNL group (59.1%, p <0.05). All patients treated with mini-PCNL were tubeless, while some patients in the standard group still needed a postoperative drainage tube (p=0.012). Complications, such as infundibulum laceration, were rare, and their differences between groups insignificant (p=1). Even though it has been demonstrated that standard sheath PCNL is considered effective for children, smaller PCNL sheaths offers more experience. Mini-PCNL provides a similar complication rate, while remaining effective in treating urolithiasis; thus, it is thought to be a non-inferior option for treating pediatric populations, especially younger and smaller children. Conclusions: Mini-PCNL is non-inferior to standard PCNL in terms of efficacy and safety for the treatment of pediatric urolithiasis. Mini-PCNL resulted in higher SFR and totally tubeless follow-up.

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“…It is of note that conversely to these observations, the European Association of Urology guidelines on urolithiasis discusses that treatment success of PCNL is hardly affected by stone size [18]. However, the evidence for stone size as an important predictor for treatment success rises [21,22]. Additionally, the reported stone-free rates after PCNL were remarkably lower when treating exclusively large kidney stones than stone size-independent studies (49-78 vs. 71-100%) [1,23].…”

Section: Discussionmentioning

confidence: 99%

Stone Localization Is Pivotal for the Success of Percutaneous Nephrolithotomy

et al. 2021

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Objective: The objective of this study was to predict computed tomography (CT)-controlled treatment success after minimally invasive percutaneous nephrolithotomy (Mini-PCNL). Patients and Methods: We relied on retrospective single institutional data from 92 kidney stone patients treated with Mini-PCNL. Residual stones after treatment were evaluated by post-Mini-PCNL CT scans. Stone-free status was defined as clinically insignificant residual stones ≤3 mm after surgery. Multivariable logistic regression analyses predicted stone-free status after Mini-PCNL. Results: Overall, 53 (57.6%) patients achieved stone-free status after Mini-PCNL treatment. In multivariable logistic regression analyses, stone localization was the strongest predictor for stone-free status after Mini-PCNL. Specifically, patients with exclusively pelvic stones were 7.1-fold more likely to achieve stone-free status than those patients with stones at multiple localizations (OR: 7.1; p = 0.005). Additionally, stone size represented a barrier for stone-free status (OR: 0.9; p = 0.03). Conclusions: Stone localization revealed the highest impact on treatment success after Mini-PCNL. Especially, those patients with exclusively pelvic stones were most likely to achieve stone-free status. Conversely, patients with multiple stone localizations were less likely to achieve stone-free status and need to be informed about higher risk of additional interventions after initial Mini-PCNL.

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Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

Cited by 8 publications

References 39 publications

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

Standard versus mini amplatz size in patients undergoing pediatric percutaneous nephrolithotomy through 16 years of experience: A retrospective study in single-center experience

Stone Localization Is Pivotal for the Success of Percutaneous Nephrolithotomy

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