The outcome of percutaneous nephrolithotomy on ≥50 mm staghorn and multiple calyceal stones

Kaya, Engin; Ebiloğlu, Turgay; Zor, Murat; Yalçın, Serdar; Çoğuplugil, Adem Emrah; Bedir, Selahattin

doi:10.5152/tud.2017.84665

Cited by 9 publications

(5 citation statements)

References 9 publications

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“…Staghorn stones have a high recurrence rate and require more interventions [11]. This was seen in a retrospective study of 2909 patients, where the staghorn stones were associated with an increased risk of bleeding requiring multiple tracts and excessive manipulation [9].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy

Ullah¹,

Ali

Karimi

et al. 2020

Cureus

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Introduction Percutaneous nephrolithotomy (PNL) has replaced open surgery for the treatment of kidney stones due to its less invasive nature. Bleeding still occurs due to renal vascular injuries, dependent upon the access route of the procedure. Several other factors are also related to the increased risk of bleeding. This study aims to find the association between blood transfusion and other factors such as age, gender, body mass index (BMI), size of the stone, operative time, preoperative hemoglobin (Hb) level, stone surface area, hypertension, and diabetes mellitus. Materials and methods This was a descriptive cross-sectional study conducted over a period of six months between November 2019 and April 2020 at a tertiary care hospital in Karachi, Pakistan. The sample size of 131 patients was calculated using open-source epidemiological software (Open-Epi). Inclusion criteria included patients from both genders and ages between 26 and 70 years. Patients ≤25 years, having a liver disease or bleeding disorders, or refusing to participate in the study, were excluded. Laboratory data included preoperative routine complete blood count, serum creatinine (normal 0.5-1.5 mg/dL), platelet count, bleeding and coagulation profile, and urine culture. All patients also underwent renal ultrasound scans. Treatment was postponed until a negative urine culture was obtained from patients with a positive urine culture. Results The mean age of the patients was 42.4 ± 15.65 years. One third (29.8%) of the patients were females. The stone size was 850 ± 121.43 mm², the mean operative time of the procedure was 125.76 ± 53.4 minutes, and the mean number of cell packs transfused was 1.10 ± 0.31 units. Blood transfusion was done in 24 (18.3%) of the patients. Gender, diabetes mellitus, stone size, preoperative Hb level, and operative time were significantly related to blood transfusion. Conclusions Increased bleeding risk while performing PNL has been associated with many factors such as operating time, the gender of the patients, and stone size. Therefore, these factors should be controlled for the procedure to decrease the risk of bleeding and the need for blood transfusion. Furthermore, the kidney vasculature should not be compromised while performing the procedure.

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Section: Discussionmentioning

confidence: 99%

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy

Ullah¹,

Ali

Karimi

et al. 2020

Cureus

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“…PCNL was firstly described in 1976 in prone position [3]. Ever since their demonstration of prone position PCNL, this surgical approach has become the gold standard for large stones treatment.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Supine Percutaneous Nephrolithotomy in Single-Center Tertiary Hospital

Ibrahim

Daniswara

Santosa

et al. 2023

Open Access Maced J Med Sci

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ABSTRACT Introduction : Percutaneous nephrolithotomy (PCNL) is currently recommended for patients with kidney stones larger than 20 mm. PCNL was firstly introduced in supine position in 1986. It demonstrated advantages in terms of ergonomics and shown to be less risky compared to prone position. However, there is still lack of evidence for the effectiveness nor safety of supine PCNL in Indonesia. Objective: To analyze the effectiveness and safety of supine PCNL in single centre tertiary hospital. Materials and Methods : 506 patients undergone supine PCNL from January 2017 to December 2021 in Dr. Kariadi general hospital were invited as sample. The retrospective data was collected from the electronic medical record system and then tabulated and analyzed using SPSS system. Results : Out of 506 samples, the mean age was 53.19±11.82 years old with the youngest being 1 year old and the oldest being 82 years old. The stone locations were calyceal; 221 patients (43.68%), pelvis; 155 patients (30.63%), and multiple; 130 patients (25.69%). The stone size was divided into two category: >20 mm; 372 patients (73.52%) and <20 mm; 134 patients (26.48%). The mean operation time was 84±41.24 minutes with the shortest being 30 minutes and the longest being 239 minutes. Supine PCNL was performed with single puncture in 495 patients (97.83%) and with multiple punctures in 11 patients (2.17%). The total stone free rate was 95.65%. 22 patients undergone another stone removal procedures after receiving supine PCNL (2nd PCNL; 6 (1.18%), ESWL; 16 (3.16%). The mean post-operative length of hospital stay was 4.1±1.48 days with the shortest being 1 day and the longest being 8 days. 28 minor complications such as infections and blood loss were recorded with only 1 case of colon perforation which is considered to be major complication. Conclusions : Supine PCNL in our centre is shown to have high stone free rate, short hospital stay, and low post-operative complications. These outcomes are the key component of this minimally- invasive procedure. Thus, mark the effectiveness and safety of supine PCNL in our centre.

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“…Urolithiasis is the third most common urological disease affecting the urinary system after urinary tract infections and prostatic pathologies; its prevalence varies between 2% and 20% worldwide. It is a multifactorial disease resulting from complex interactions between environmental and genetic factors [ 1 , 2 ]. It has been shown to have a significant relationship with obesity and metabolic syndrome, which are common in countries with a high standard of living [ 3 , 4 , 5 ], where obesity gradually increases due to dietary factors and inactive lifestyles caused by technological development.…”

Section: Introductionmentioning

confidence: 99%

Visceral adiposity index in kidney stone patients who have undergone surgery

Sönmez

Kılınç

Göksoy

et al. 2022

Cent european J Urol

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Introduction The visceral adiposity index (VAI) is a gender-specific metabolic index that indirectly measures visceral adipose function and distribution using waist circumference, body mass index (BMI), and triglyceride and high-density lipoprotein (HDL) cholesterol values. To assess visceral fat in the diagnostic pathway of urinary stone patients, we investigated the relationship between the VAI and nephrolithiasis as well as the relationship between the VAI and stone and surgery-related parameters. Material and methods Patients who underwent percutaneous nephrolithotomy and retrograde intrarenal surgery for kidney stones were included in the study. The control group comprised of healthy individuals who volunteered to take part in study and did not have urolithiasis as confirmed by abdominal computed tomography imaging. A total of 148 patients were divided into the nephrolithiasis (n = 103) and the control (n = 45) groups. Weight, height, BMI, waist circumference measurements, and VAI were among the metabolic parameters measured. Stone and surgical parameters were evaluated. Results VAI (4.57 vs 2.76), waist circumference (92.1 vs 87.1), and BMI (28.31 vs 26.51) values were higher in the nephrolithiasis group(p = 0.02,p = 0.04, p <0.001,respectively). The VAI was statistically significant in the multivariate analysis for the presence of nephrolithiasis (p <0.001). The VAI negatively correlated with the stone Hounsfield unit (HU) and positively correlated with very-low-density lipoprotein (VLDL), blood creatinine, and calcium levels. The relationship between VAI and surgical parameters was not significant. Conclusions A significant relationship was detected between nephrolithiasis and VAI, a new gender-specific metabolic index that distinguishes between subcutaneous and visceral adipose mass and demonstrates metabolic syndrome. No significant effect of this relationship on surgical parameters was demonstrated in the present study.

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The outcome of percutaneous nephrolithotomy on ≥50 mm staghorn and multiple calyceal stones

Cited by 9 publications

References 9 publications

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy

The Effectiveness and Safety of Supine Percutaneous Nephrolithotomy in Single-Center Tertiary Hospital

Visceral adiposity index in kidney stone patients who have undergone surgery

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