Suctioning Minimally Invasive Percutaneous Nephrolithotomy with a Patented System Is Effective to Treat Renal Staghorn Calculi: A Prospective Multicenter Study

Du, Chengchao; Song, Leming; Wu, Xiaoyuan; Fan, Daiming; Zhu, Ling; Liu, Shengfeng; Deng, Xiaolin; Liu, Tairong; Yang, Zhongsheng; Peng, Zhe; Hu, Min; Liu, Qigui; Pan, Tiejun; Chen, Zhiqiang; Ye, Zhangqun

doi:10.1159/000488399

Cited by 29 publications

(51 citation statements)

References 10 publications

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“…We also excluded from our analysis: one article with insu cient data, one article without full text, and one review article. Finally, three randomized controlled trials (RCTs) and two case-controlled trials (CCTs) with 1163 patients that satis ed all the inclusion criteria were subjected to the meta-analysis [15][16][17][18][19]. The article selection process was followed by the PRISMA statement (Fig 1).…”

Section: Resultsmentioning

confidence: 99%

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Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Zhu

Wang

Zhou

et al. 2021

Preprint

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Background A systematic review and meta-analysis was conducted to compare the safety and efficacy between the vacuum-assisted sheath and conventional sheath in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis. Methods PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2021) were searched for studies assessing the effect of vacuum-assisted sheath in patients who underwent MPCNL. The search strategy and study selection processes were managed according to the PRISMA statement. Results Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheath was significantly higher than those who underwent conventional sheath (RR = 1.18, 95% CI = 1.08,1.29; P = 0.0002), with insignificant heterogeneity among the studies (I2 = 44%, P = 0.13). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR = 0.45, 95%CI = 0.33,0.61; P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.76). There was no significant difference in blood transfusion rate (RR = 0.54, 95%CI = 0.23,1.29; P = 0.17) with insignificant heterogeneity (I2 = 41%, P = 0.15,). Only two studies reported the perforation and the results were statistically insignificant (RR = 0.25, 95%CI = 0.05,1.17; P = 0.08) with insignificant heterogeneity (I2 = 0%, P = 0.43). Conclusions Using vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. Vacuum-assisted sheath significantly increases the SFR and reduces complications like postoperative infection, blood transfusion, and perforation

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Section: Resultsmentioning

confidence: 99%

“…The JADAD score for three studies was 2, 3, and 4. One study is of low quality as no blinding was used and the report of explanation of the speci c method of randomization [15,16,19]. The MINORS score for the two studies were 20 and 22, respectively [17,18].…”

Section: Resultsmentioning

confidence: 99%

Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Zhu

Wang

Zhou

et al. 2021

Preprint

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“…Clinically, the main reasons for urosepsis are the following: (1) MPCNL has been performed on patients with UTI before the infection is fully controlled; (2) the possibility of live pathogenic bacteria in infectious stones; (3) complex renal stones, with heavy loads and a long operation time; (4) excessively high intrarenal pressure intraoperatively [19][20][21][22][23]. In this study, we focused on patients who underwent MPCNL with preoperative UTI for a more sensitive and effective observation of the impacts of surgical factors on sepsis, aiming to reduce sepsis incidence by improving surgical procedures and methods.…”

Section: Discussionmentioning

confidence: 99%

“…e longer the operative time, the higher the risk of sepsis. Previous studies have also revealed that the risk of infection is significantly increased with a surgical time longer than 90 min during PCNL [17,19]. Operative time mainly depends on stone loads and channel size.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Urosepsis after Minimally Invasive Percutaneous Nephrolithotomy in Patients with Preoperative Urinary Tract Infection

Wang

Yuan

Peng

et al. 2020

BioMed Research International

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The purpose of this study was to assess risk factors of urosepsis after minimally invasive percutaneous nephrolithotomy (MPCNL) for the treatment of upper urinary tract stones in patients with preoperative urinary tract infection (UTI) and to explore preventive measures. Between 2008 and 2016, patients with preoperative UTI who underwent MPCNL for upper urinary tract stones were retrospectively collected. Patients were divided into nonurosepsis and urosepsis groups. Perioperative outcomes of all patients were evaluated and compared between the two groups. Risk factors for post-MPCNL urosepsis were investigated using univariate and multivariate regression analysis. A total of 843 patients including 22 patients with postoperative urosepsis (urosepsis group) and 821 patients without urosepsis (nonurosepsis group) were finally included in this study. All patients with postoperative urosepsis were cured and discharged after treatment. In univariate analysis it was demonstrated that the incidence of urosepsis after MPCNL was significantly correlated with channel size (P=0.001), surgical time (P=0.003), as well as the tear of the collection system and percutaneous renal channel crossing the renal papilla (P=0.004). Moreover, multivariate analysis showed that smaller channel size (OR = 11.192, 95% CI: 2.425–51.650, P=0.002), longer surgical time (OR = 6.762, 95% CI: 1.712–17.844, P=0.008), and tear of collection system and percutaneous renal channel crossing the renal papilla (OR = 5.531, 95% CI 1.228–14.469, P=0.012) were independent risk factors for urosepsis following MPCNL in patients with preoperative UTI. In conclusion, in patients with preoperative UTI undergoing MPCNL for upper urinary tract stones, smaller channel size, prolonged operation time, as well as tear of the collection system and percutaneous renal channel crossing the renal papilla are independent risk factors for postoperative urosepsis. Therefore, it is indicated that, in clinical practice, it is of great significance to choose appropriate channel size and avoid renal injury and control surgical time to prevent the urosepsis after MPCNL in patients with preoperative UTI.

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“…Many studies have shown that about half of PCNL in children using adult-type instruments have no serious complications. Although MPCNL is already widely accepted, the system is mainly used to remove stones by high pressure perfusion or manual excision with forceps, resulting in intraoperative or postoperative fever, sepsis or septic shock [21], in addition to complications such as hemorrhage and extravasation [22]. MPCNL postoperative indwelling nephrostomy will sometimes lead to pain and nursing requirements.…”

Section: Discussionmentioning

confidence: 99%

Super-Mini Percutaneous Nephrolithotomy Reduces the Incidence of Postoperative Adverse Events in Pediatric Patients: A Retrospective Cohort Study

et al. 2019

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Objective: To assess the safety of the super-mini percutaneous nephrolithotomy (SMP) versus the minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of pediatric renal calculus. Methods: We retrospectively reviewed the electronic records of pediatric patients who underwent treatment for renal stones by either SMP or MPCNL from May 2015 to May 2016. We compared the safety of the 2 surgical procedures in the treatment of renal calculus in children by using the generalized estimating equation (GEE) multivariate regression analysis, in which the exposures are the surgical procedures and postoperative adverse events (postoperative complications, fever, and WBC counts) are set as outcome variables. Results: The study included 39 patients (26 boys and 13 girls), of which 22 underwent MPCNL and 17 underwent SMP, with a mean age of 110.05 ± 45.01 and 93.18 ± 41.72 months, respectively. In the univariate logistic regression model, the surgical procedures showed no significant association with postoperative complications (95% CI 0.0–1.5), fever (95% CI 0.1–2.1), postoperative peripheral WBC (95% CI 0.1–2.2). In the multiple logistic regression analysis, there was an insignificant association between surgical methods and postoperative complications (95% CI 0.28–1.1), fever (95% CI 0.1–1.2), and postoperative peripheral WBC (95% CI 0.03–1.8). While using GEE with multiple dependent variables and MPCNL as a reference, the OR of adverse events was 0.15 and the 95% CI were 0.04–0.55. Conclusions: Compared to MPCNL, SMP has a lower incidence of postoperative complications and appears to be a safer treatment for children with kidney stones.

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Suctioning Minimally Invasive Percutaneous Nephrolithotomy with a Patented System Is Effective to Treat Renal Staghorn Calculi: A Prospective Multicenter Study

Cited by 29 publications

References 10 publications

Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Risk Factors for Urosepsis after Minimally Invasive Percutaneous Nephrolithotomy in Patients with Preoperative Urinary Tract Infection

Super-Mini Percutaneous Nephrolithotomy Reduces the Incidence of Postoperative Adverse Events in Pediatric Patients: A Retrospective Cohort Study

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