Flexible Nephroscopy: A Step Towards Complete Stone Clearance in PCNL

Thirugnanasambandam, Vasudevan; Kone, Kalyanram

doi:10.22374/jeleu.v4i1.112

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Stone fragmentation is performed using an ultrasonic lithotripter (Olympus Medical) (tracts > 16 Fr) or laser energy (Lumenis) (tracts < 16 Fr). Flexible nephroscopy is usually performed at the end of the procedure to assess the residual stone fragments (14), and a double J stent (Boston Scienti c) is introduced retrogradely at the conclusion of the procedure. In circumstances when serious bleeding, perforation of the collecting system, or infection of the system is likely, a nephrostomy tube is left in place.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

Perez,

Neeman,

Dotan

et al. 2023

Urolithiasis

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Percutaneous nephrolithotomy (PCNL) is considered gold standard treatment of renal stones larger than 20mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than uoroscopy. A higher body mass index (BMI) can make ultrasound-guided renal access more di cult and unsuccessful. We present a prospective analysis and comparison of ultrasound-guided PCNL in patients with normal and increased body mass index.We performed a prospective comparison of patients who underwent ultrasound-guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87-Obese) were compared to those with BMIs less than 30 (mean 25.69-non-Obese). Demographic, perioperative, and follow-up data were collected, analyzed, and included in this study.Total of 98 consecutive patients, with 49 patients in each group. No statistically signi cant differences were observed in terms of stone volume (p = 0.085), stone density (P = 0.5590), location of renal access (P = 0.108), surgery duration (P = 0.38), blood loss (P = 0.54), or laboratory changes after surgery (P = 0.60). 87.76% of obese patients were stone-free per CT scan at follow-up, compared to 73.47% of normalweight patients (P = 0.1238). According to Clavien Dindo classi cation, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to six patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications.There was no signi cant correlation between body mass index and the success or safety of ultrasoundguided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone-free status post-operatively and can diminish or avoid both patient's and medical team's exposure to ionizing radiation.

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Section: Surgical Proceduresmentioning

confidence: 99%

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

Perez,

Neeman,

Dotan

et al. 2023

Urolithiasis

View full text Add to dashboard Cite

show abstract

Ultrasound- Guided Percutaneous Nephrolithotomy (PCNL) Success Rates in Patients with Elevated Body Mass Index: A Comparative study

Perez,

Neeman,

Dotan

et al. 2023

Preprint

View full text Add to dashboard Cite

Percutaneous nephrolithotomy (PCNL) is considered gold standard treatment of renal stones larger than 20mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than fluoroscopy. A higher body mass index (BMI) can make ultrasound-guided renal access more difficult and unsuccessful. We present a prospective analysis and comparison of ultrasound-guided PCNL in patients with normal and increased body mass index. We performed a prospective comparison of patients who underwent ultrasound-guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87- Obese) were compared to those with BMIs less than 30 (mean 25.69- non-Obese). Demographic, perioperative, and follow-up data were collected, analyzed, and included in this study. Total of 98 consecutive patients, with 49 patients in each group. No statistically significant differences were observed in terms of stone volume (p = 0.085), stone density (P = 0.5590), location of renal access (P = 0.108), surgery duration (P = 0.38), blood loss (P = 0.54), or laboratory changes after surgery (P = 0.60). 87.76% of obese patients were stone-free per CT scan at follow-up, compared to 73.47% of normal-weight patients (P = 0.1238). According to Clavien Dindo classification, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to six patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications. There was no significant correlation between body mass index and the success or safety of ultrasound-guided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone-free status post-operatively and can diminish or avoid both patient’s and medical team’s exposure to ionizing radiation.

show abstract

Flexible Nephroscopy: A Step Towards Complete Stone Clearance in PCNL

Cited by 2 publications

References 9 publications

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

Ultrasound- Guided Percutaneous Nephrolithotomy (PCNL) Success Rates in Patients with Elevated Body Mass Index: A Comparative study

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