Percutaneous kidney stone surgery and radiation exposure: A review

Baralo, Bohdan; Samson, Patrick; Hoenig, David M.; Smith, Arthur D.

doi:10.1016/j.ajur.2019.03.007

Cited by 10 publications

(8 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The topic of radiation exposure has become increasingly important in management of renal stones. 26 The reduction of FT and patient effective dose observed in the vmPCNL group can be explained by several reasons. First, radiation exposure usually increases along with OT, which in turn rises along with the use of a flexible ureteroscope for fragment retrieval, all of which were advantageous for the vmPCNL group, compared with the MIP group.…”

Section: Resultsmentioning

confidence: 99%

Clinical Comparison of Mini-Percutaneous Nephrolithotomy with Vacuum Cleaner Effect or with a Vacuum-Assisted Access Sheath: A Single-Center Experience

Lievore

Boeri

Zanetti

et al. 2021

Journal of Endourology

View full text Add to dashboard Cite

Purpose: To compare outcomes of two different miniaturized percutaneous nephrolithotomy (PCNL) techniques: minimally invasive PCNL (MIP) with the vacuum cleaner effect and vacuum-assisted mini-PCNL (vmPCNL). Materials and Methods: Data from 104 (66.7%) patients who underwent vmPCNL and 52 (33.3%) patients who underwent MIP at a single tertiary referral academic center between January 2016 and December 2019 were analyzed. Patient demographics and peri-and postoperative data were recorded, and propensity score matching was performed. Descriptive statistics and linear regression models were used to identify variables associated with operative time (OT) and patient effective dose. Logistic regression analyses were used to identify factors associated with infectious complications and stone-free (SF) status. Results: Patient demographics and stone characteristics were comparable between groups. vmPCNL was associated with shorter OT ( p < 0.001), fluoroscopy time, and patient effective dose (4.2 mSv vs 7.9 mSv; p < 0.001). A higher rate of infectious complications was found in the MIP group (25.0% vs 7.7%, p < 0.01). Linear regression analysis showed that stone volume, multiple stones, and MIP procedure (all p values £0.02) were associated with longer OT. Similarly, OT and the MIP procedure ( p £ 0.02) were associated with higher patient effective dose. Logistic regression analysis revealed that the stone volume, positive preoperative bladder urine culture, and MIP procedure (all p values £0.02) were associated with postoperative infectious complications. vmPCNL was not associated with the SF rate. Conclusions: Mini-PCNL performed with continuous active suction is associated with lower rates of infectious complications, shorter OT, and lower patient effective dose than MIP.

show abstract

Section: Resultsmentioning

confidence: 99%

Clinical Comparison of Mini-Percutaneous Nephrolithotomy with Vacuum Cleaner Effect or with a Vacuum-Assisted Access Sheath: A Single-Center Experience

Lievore

Boeri

Zanetti

et al. 2021

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…Minimizing x-ray exposure during percutaneous renal access is challenging. To date many techniques other than the one-shot dilation technique have been developed to decrease x-ray exposure 22 . Some techniques, such as a specific protocol for fluoroscope use and ultrasound guided access, could potentially be initiated in our hospital in the future.…”

Section: Discussionmentioning

confidence: 99%

One-shot dilation versus metallic dilation technique for access in percutaneous nephrolithotomy: comparison of efficacy, access time and fluoroscopic time

Phaijitwichian¹

2021

Insight Urol

View full text Add to dashboard Cite

Objective: The aim of this study was to compare the efficacy, access tract dilation time and fluoroscopic time between the one-shot dilation technique and telescopic metal dilatation technique in patients undergoing percutaneous nephrolithotomy in Nakornping Hospital. Materials and Methods: Sixty-six patients who underwent percutaneous nephrolithotomy from January 2020 to July 2021 were included in the study and they were randomly divided into two groups. In group 1 (32 patients), telescopic metal dilation was used, in group 2 (33 patients), the one-shot technique was used. Success rates of dilation, access tract dilation time and fluoroscopic time were evaluated. Results: The success rate of dilation was 100% in both groups. The access tract dilation time was 835.63 ± 309.68 seconds in group 1 and 569.42 ± 314.75 seconds in group 2 (p = 0.001). The fluoroscopic time was 48.16 ± 22.16 seconds in group 1 and 41.97 ± 23.99 seconds in group 2 (p = 0.29). The access tract dilation time of the one-shot dilation technique was statistically significantly shorter than that in the telescopic metal dilatation group. The mean fluoroscopic time of the one- shot dilation technique was shorter than in telescopic metal dilatation but was not statistically significant. Conclusion: One-shot dilation technique is as effective as telescopic metal dilatation, with a significant reduction in access tract dilation time.

show abstract

“…Fluoroscopic guidance is the mainstay imaging for the renal access step in PCNL, but it can cause radiation exposure in patients and medical personnel. 3 Ultrasound guidance is a reliable alternative type of imaging for direct PCNL. It can minimize radiation exposure and there is no need for contrast media.…”

Section: Discussionmentioning

confidence: 99%

“…2 Given the concerns regarding cumulative radiation effects, ultrasound (US)-guided renal stone access is a reliable alternative imaging method to PCNL for avoiding ionizing radiation exposure. 3 Interestingly, US-guided renal stone access has not been adopted worldwide; this technique has been widely used only in Asia. [4][5][6][7][8] We have successfully performed US-guided PCNL (US-PCNL) in our hospital for renal stone treatment since 2014.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Outcomes between Ultrasound-Guided PCNL in Lateral Position and Open Nephrolithotomy for Patients with Staghorn Renal Stones

Pimratana¹,

Wijitsettakul²,

Cheunganuwat³

2021

Siriraj Med J

View full text Add to dashboard Cite

Objective: To compare the clinical outcomes of ultrasound-guided percutaneous nephrolithotomy (US-PCNL) in lateral position and anatrophic nephrolithotomy (ANL) in the treatment of staghorn renal stones.Methods: This study includes individuals with staghorn renal stones who had an operation at Buri Ram Hospital in Thailand between October 2016 and July 2020. They were divided into two groups; group I includes patients undergoing US-PCNL (n= 114) and group II includes patients undergoing ANL (n=112). The outcomes regarding stone-free rates, the stone clearance rate, operative times, length of hospitalization, and complications were collected and analyzed.Results: The patient’s demographics and stone characteristics were not significantly different between the two groups, except that the ANL group had more preoperative hydronephrosis (78.6% vs. 53.5%, p < 0.001). Regarding the primary outcome, the stone-free rate was significantly lower in the US-PCNL group (47.4% vs. 75.9%, p < 0.001), whereas the stone clearance rate was not significantly different (96.4±6.0% in the US-PCNL group and 97.7±5.8% in the ANL group, p = 0.098). The major and minor complications between the two groups were not significantly different; however, the US-PCNL group had a significantly lower transfusion rate than the ANL group (3.5% vs. 17.9%, p < 0.001). The total operative time in both groups was not different; however, the length of stay at hospital for the US-PCNL was significantly shorter than for the ANL group (10.0 vs. 12.9 days, p = 0.002).Conclusion: The ANL had a higher stone-free rate; however, the stone clearance rate was not significantly different between the US-PCNL and ANL groups. There were many advantages of the US-PCNL over the ANL, such as less blood transfusion, shorter length of hospitalization, and no radiation exposure for the patients or the medical personnel, while the complications were not different between the two groups.

show abstract

Percutaneous kidney stone surgery and radiation exposure: A review

Cited by 10 publications

References 38 publications

Clinical Comparison of Mini-Percutaneous Nephrolithotomy with Vacuum Cleaner Effect or with a Vacuum-Assisted Access Sheath: A Single-Center Experience

Clinical Comparison of Mini-Percutaneous Nephrolithotomy with Vacuum Cleaner Effect or with a Vacuum-Assisted Access Sheath: A Single-Center Experience

One-shot dilation versus metallic dilation technique for access in percutaneous nephrolithotomy: comparison of efficacy, access time and fluoroscopic time

Comparison of the Outcomes between Ultrasound-Guided PCNL in Lateral Position and Open Nephrolithotomy for Patients with Staghorn Renal Stones

Contact Info

Product

Resources

About