Predictors of Immediate Postoperative Outcome of Single-tract Percutaneous Nephrolithotomy

Shahrour, Khaled; Tomaszewski, Jeffrey J.; Ortiz, Tara; Scott, Emily; Sternberg, Kevan; Jackman, Stephen V.; Averch, Timothy D.

doi:10.1016/j.urology.2011.12.065

Cited by 54 publications

(38 citation statements)

References 15 publications

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“…[2][3][4] Stone-free rate for PNL in a single session consisting of 180 patients was 51%, and upper pole stones and greater size have been associated with lower rates of attaining stone-free states. 5 Turna et al demonstrated an overall stone-free rate of 78.6%, which decreased with increasing stone size and caliceal component. 6 To our knowledge, studies on surgical outcomes of LP in patients classified according to stone distribution within the kidney have not been reported in the literature.…”

Section: Discussionmentioning

confidence: 95%

“…15 Predictive factors associated with surgical outcomes of these modalities have been reported to be total stone burden and location of stone burden. [2][3][4][5][6] Stone-free rates for SWL ranged from 45% to 99%, depending on stone location, burden, and composition. [2][3][4] Stone-free rate for PNL in a single session consisting of 180 patients was 51%, and upper pole stones and greater size have been associated with lower rates of attaining stone-free states.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, surgical outcomes of these modalities widely vary depending on total stone burden, location of stone burden, stone composition, and anatomy of the collecting system. [2][3][4][5][6] In large or complex renal stones located in multiple calyces, it may be difficult to achieve complete stone clearance in a single session. Such cases may require multiple procedures or multiple access tracts during PNL, which increase the risk for significant complications such as renal parenchymal injury or massive hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Pyelolithotomy: Comparison of Surgical Outcomes in Relation to Stone Distribution Within the Kidney

Lee

Cho

Yeon

et al. 2013

Journal of Endourology

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Purpose: To evaluate surgical outcomes of laparoscopic pyelolithotomy (LP) in relation to stone distribution within the kidney. Methods: Between August 2008 and February 2012, 77 patients underwent LP as first-line treatment for renal stone(s). Cases were classified into four groups, depending on stone location: Group I (located in only renal pelvis), Group II (located only in renal calyx), Group III (located in renal pelvis and in one calyx), and Group IV (located in renal pelvis and in multiple calyces). Patient and stone characteristics, surgical outcomes, and complications were evaluated. Results: Sixty-seven (81.8%) cases were stone-free after LP for large renal stones. Stone-free rates in a single session significantly decreased with greater stone dispersion ( p < 0.001). Mean hospital stay in group IV was significantly longer than in other groups ( p = 0.038). However, there were no significant differences in mean operation times ( p = 0.214), mean change in serum hemoglobin ( p = 0.709), postoperative analgesics usages ( p = 0.153), and number of analgesics used on an as-needed basis ( p = 0.079). There were no complications of grade IIIb or of greater severity. One patient in group II received blood transfusion, and 1 in group III required percutaneous drainage due to perirenal urine collection. Conclusions: LP is an effective and safe modality for managing renal stones diseases. Distribution of stone burden, and total stone burden, is an important predictor of surgical outcome of LP in renal stone diseases.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Pyelolithotomy: Comparison of Surgical Outcomes in Relation to Stone Distribution Within the Kidney

Lee

Cho

Yeon

et al. 2013

Journal of Endourology

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“…This large multicenter study included a mean stone burden of only 463 mm 2 , used only plain film imaging, and defined stone free as residual stone fragments < 4 mm. More recently, Shahrour and coworkers 28 reported stone-free rates of 51% after a single PCNL procedure in 351 patients, evaluated by a postoperative CT scan or intraoperative antegrade fluoroscopy. Lastly, the British Association of Urological Surgeons PCNL data registry of 1009 patients reported stone-free rates of 47% and 77% for staghorn and nonstaghorn calculi, respectively, using less stringent criteria.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome

Iqbal

Youssef

Neisius

et al. 2016

Journal of Endourology

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Struvite stones can be managed safely with PCNL followed by medical therapy. The majority of patients with residual fragments demonstrated no evidence of stone growth on medical therapy. With careful follow-up and medical management, kidney function can be maintained and stone morbidity can be minimized. Initial large stone burden, residual stones after surgery, and associated medical comorbidities may have deleterious effect on stone recurrence or residual stone-related events.

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“…Percutaneous nephrolithotomy (PCNL) is known to provide best stone-free rate among all available treatments for renal stones (1,2) and it has been recommended as "standard" for stones larger than 20 mm. Safety of PCNL has been established on the basis of various studies and resources (3).…”

Section: Introductionmentioning

confidence: 99%

Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless

Siddiq¹,

Khalid²,

Mahmud³

et al. 2018

jus

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Objective: To determine the scope of tubeless (TL) supracostal percutaneous nephrolithotomy (PCNL) in terms of safety through a randomized controlled trial. Materials and Methods: Adult patients (>14 years) undergoing supracostal PCNL were randomized into two groups (25 patients each), by randomizing odd number for supracostal PCNL with tube (WT) as group A and for TL supracostal PCNL as group B. Both groups received injectable analgesia on operative day and oral analgesia from the first post-operative day. Pain severity was objectively assessed by a visual analogue scale (VAS). Chest X-ray and kidney ultrasonography were done to detect any pleural effusion and perinephric collection. These complications along with thoracostomy and endotracheal intubation were compared between the groups. Results: The mean (VAS) score in group A and B was 7.88±0.83 and 4.12±0.83, respectively (p=0.01). Four of 25 (16%) patients in group A and 1 of 25 (4%) patients in group B developed pleural effusion. Two patients (8%) in group A and 1 patient (4%) in group B required tube thoracostomy (p=0.56). One patient (4%) in group A and 2 patients (8%) in group B developed perinephric collection (p=0.56). A single patient in each group (2%) developed respiratory distress needing elective intubation and ventilation (p=1.00). The mean hospital stay in group B (4.12±0.52 days) was shorter than in group A (4.68±0.85 days) (p=0.01). Conclusion: Tubeless supracostal PCNL is less painful than supracostal PCNL WT, without difference in complication rates. Supracostal PCNL (TL) has a shorter hospital stay. Keywords: Percutaneous nephrolithotomy, Supracostal, Pleural effusion, Thoracostomy Amaç: Tüpsüz suprakostal perkütan nefrolitotominin (PNL), randomize kontrollü çalışma ile güvenlik açısından kapsamını belirlemek. Gereç ve Yöntem: Suprakostal PNL uygulanan erişkin hastalar (>14 yıl), tüplü suprakostal PNL için A grubu olarak ve tüpsüz suprakostal PNL için B grubu olarak iki gruba tek sayı randomize edildi (her biri 25 hasta). İki grup ameliyat günü enjektabl analjezi ve operasyon sonrası ilk günden itibaren oral analjezi aldı. Ağrı şiddeti görsel analog ölçeği (GAÖ) ile objektif olarak değerlendirildi. Plevral efüzyon ve perinefrik koleksiyonu saptamak için göğüs X-ray ve böbrek ultrasonu yapıldı. Torakostomi ve endotrakeal entübasyon ile birlikte bu komplikasyonlar gruplar arasında karşılaştırıldı. Bulgular: Grup A ve B ortalama GAÖ skoru sırasıyla 7,88±0,83 ve 4,12±0,83 idi (p=0,01). Grup A'da 25 hastanın 4'ünde (%16) ve grup B'de 25 Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless TubelessGün Boyu Ağrılı Standart Nefrostomiye Karşı Ağrısız Tüpsüz-Suprakostal PNL Supracostal access during percutaneous nephrolithotomy has become a fear factor among the urological fraternity. leaving a drainage tube postoperatively has become a beacon of safety. But the evidence proving this notion is feeble. This study adds to the evidence which proves that drainage is not necessary in supracostal access during a very common urological...

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Predictors of Immediate Postoperative Outcome of Single-tract Percutaneous Nephrolithotomy

Cited by 54 publications

References 15 publications

Laparoscopic Pyelolithotomy: Comparison of Surgical Outcomes in Relation to Stone Distribution Within the Kidney

Laparoscopic Pyelolithotomy: Comparison of Surgical Outcomes in Relation to Stone Distribution Within the Kidney

Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome

Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless

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