The effects of previous open renal stone surgery types on PNL outcomes

Abstract

E246Cite as: Can Urol Assoc J 2016;10(7-8) Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study. Results: 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%). Conclusions: Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure.

An Investigation on the Patients Undergoing Kidney Stone Open Surgery: A Single-Center Report From Sistan and Baluchistan Province, Iran

“…In the study of Çakici et al 9 and Aydemir et al, 13 the most common stones leading to open surgery were staghorn stones. Other studies by Ozgor et al 11 and El-Husseiny & Buchholz 14 also showed that the most common stones leading to open surgery were staghorn types. Actually, the renal structural changes created by staghorn stones in most cases force the physician to consider surgery to remove the stone.…”

“…However, in a study by Ozgor et al, this ratio did not show a significant deviation despite the fact that men were still more likely to be candidates for surgery. 11 The reason for the higher prevalence of urinary stones in males may be due to the higher secretion of calcium oxalate and uric acid and less citrate production in men than women, leading to more severe complications. 12 In the present study, almost half of the patients were identified with staghorn stones.…”

Costs variations for percutaneous nephrolithotomy in the U.S. from 2003–2015: A contemporary analysis of an all-payer discharge database

“…Secondly, as with any secondary analysis of an administrative database, it may be prone to coding errors leading to misclassification bias. Thirdly, the retrospective design of our study subjects it to selection bias and unmeasured variables such as prior surgery, 29 obesity, [30][31][32] stone complexity, 33 burden, location of calculi, number of punctures, 34 approach (supine/prone) 35 , exit strategy (tube or tubeless) 36 , and need for secondary procedures, which may impact outcomes and costs. Fourthly, we were only able to capture inpatient hospitalization requiring at least 1 night of hospital stay.…”

New surgical technique applied with urological instruments in bilobar multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy

“…This method has been successfully applied by urologists in many centers with very high stone-free rates. [4] Ultramini percutaneous nephrolithotomy performed using minimal invasive tools has been applied with success thanks to accumulated PNL experience and the technological developments. [5] So with the experience gained in PNL, ultra-mini percutaneous hepatolithotomy can be used for the treatment in hepatolithiasis cases with high morbidity.…”