Variables That Influence Operative Time During Percutaneous Nephrolithotomy: An Analysis of 1897 Cases

Akman, Tolga; Binbay, Murat; Akçay, Muzaffer; Tekinarslan, Erdem; Kezer, Cem; Özgör, Faruk; Seyrek, Mahir; Müslümanoğlu, Ahmet Yaser

doi:10.1089/end.2011.0061

Cited by 47 publications

(38 citation statements)

References 23 publications

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“…In another study, Akman et al found a cut-off point for blood transfusion as 58 min. The demonstrated predictive factors for bleeding were the number of access points, stone type (staghorn or other), diabetes mellitus, preoperative Hb level, and operation time of up to 58 min in their study (22). In the present study, if the operation time was longer than 90 min according to the ROC analysis, transfusion requirement and also bleeding risk would be increased (odds ratio = 8.03, relative risk = 5.2; Figure 1).…”

Section: Discussionmentioning

confidence: 46%

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Rifaioğlu¹,

Önem²,

Çelik³

et al. 2013

Turk J Med Sci

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Ion probe dating is used to determine the relative ages of amphibolite-facies meta-clastic sedimentary rocks and crosscutting granitoid rocks within an important 'basement' outcrop in northwestern Turkey. U-Pb ages of 89 detrital zircon grains separated from sillimanite-garnet micaschist from the Central Sakarya basement terrane range from 551 Ma (Ediacaran) to 2738 Ma (Neoarchean). Eighty fi ve percent of the ages are 90-110% concordant. Zircon populations cluster at ~550-750 Ma (28 grains), ~950-1050 Ma (27 grains) and ~2000 Ma (5 grains), with smaller groupings at ~800 Ma and ~1850 Ma. Th e fi rst, prominent, population (late Neoproterozoic) refl ects derivation from a source area related to a Cadomian-Avalonian magmatic arc, or the East African orogen. An alternative Baltica-related origin is unlikely because Baltica was magmatically inactive during much of this period. Th e early Neoproterozoic ages (0.9-1.0 Ga) deviate signifi cantly from the known age spectra of Cadomian terranes and are instead consistent with derivation from northeast Africa. Th e detrital zircon age spectrum of the Sakarya basement is similar to that of Cambrian-Ordovician sandstones along the northern periphery of the Arabian-Nubian Shield (Elat sandstones). A sample of crosscutting pink alkali feldspar-rich granitoid yielded an age of 324.3±1.5 Ma, whilst a grey, well-foliated biotite granitoid was dated at 327.2±1.9 Ma. A granitoid body with biotite and amphibole yielded an age of 319.5±1.1 Ma. Th e granitoid magmatism could thus have persisted for ~8 Ma during late Early Carboniferous time, possibly related to subduction or collision of a Central Sakarya terrane with the Eurasian margin. Th e Central Sakarya terrane is likely to have rift ed during the Early Palaeozoic; i.e. relatively early compared to other Eastern Mediterranean, inferred 'Minoan terranes' and then accreted to the Eurasian margin, probably during Late Palaeozoic time. Th e diff erences in detrital zircon populations suggest that the Central Sakarya terrane was not part of the source area of Lower Carboniferous clastic sediments of the now-adjacent İstanbul terrane, consistent with these two tectonic units being far apart during Late Palaeozoic-Early Mesozoic time.

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Section: Discussionmentioning

confidence: 46%

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Rifaioğlu¹,

Önem²,

Çelik³

et al. 2013

Turk J Med Sci

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“…8,15,16,20,21 In other studies, stone surface area or stone size significantly affected complications and mean Clavien score. 3,17 Moreover, stone location, staghorn and complex stones had a significant influence on mean Clavien score, Clavien grades, or complications in some studies. 3,10,16,21,34 In other studies, stone distribution and staghorn stone had no significant effect on complications or grade ≥IIIa.…”

Section: Discussionmentioning

confidence: 99%

“…3,10,16,21,34 In other studies, stone distribution and staghorn stone had no significant effect on complications or grade ≥IIIa. 6,17 Puncturing, access and stone removal largely affect PCNL complications. 4 Stone characteristics may have eligible effects on the occurrence and severity of PCNL complications.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8]10,12 Compared with others studies, we had comparative results about complete supine PCNL complications according to the MCC. [3][4][5][6][7][8]10,12,[15][16][17] The types of complications, their management, and outcomes affect this classification.9,12 Therefore the MCC can be used to evaluate the severity of complications, yet it has its limitations. The MCC cannot predict the occurrence of a specific complication and cannot reveal its reason.…”

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confidence: 99%

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Factors affecting complications according to the modified Clavien classification in complete supine percutaneous nephrolithotomy

Falahatkar¹,

Moghaddam

Kazemnezhad³

et al. 2015

CUAJ

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Cite as: Can Urol Assoc J 2015;9(1-2):e83-92. http://dx.doi.org/10.5489/cuaj.2248 Published online February 9, 2015. AbstractIntroduction: An increase in percutaneous nephrolithotomy (PCNL) has been accompanied by an increase in complications. We identified the parameters affecting the severity of complications using the modified Clavien classification (MCC). Methods: From 2008 to 2013, 330 patients underwent complete supine PCNL using subcostal access, one-shot dilation, rigid nephroscopy, and pneumatic lithotripsy. We assessed the impact of the following factors on complication severity based on the MCC: age, gender, body mass index, hypertension, diabetes, previous stone surgery and extracorporeal shock wave lithotripsy, preoperative hemoglobin, renal dysfunction (creatinine >1.4 mg/dL), preoperative urinary tract infection, anatomic upper urinary tract abnormality (AUUTA), significant (moderate-severe) hydronephrosis, stonerelated parameters (opacity, number, burden, location, staghorn, complex stones), anesthesia type, kidney side, imaging and calyx for access, tract number, tubeless approach, operative time, postoperative hemoglobin, and hemoglobin drop and stone-free results. Results: The complication rate was 19.7% (MCC: 0=80.3%, I=6.4%, II=11.2%, ≥III=2.1%). On univariate analyses, only the following factors affected MCC: gender, preoperative hemoglobin, AUUTA, significant hydronephrosis, imaging for access, calyx for access, tract number, postoperative hemoglobin, hemoglobin drop and stone-free result. Renal dysfunction was accompanied by higher complications, yet the results were not statistically significant. Multivariate logistic regression analysis demonstrated renal dysfunction, absence of significant hydronephrosis, AUUTA, multiple tracts, lower postoperative hemoglobin, and higher postoperative hemoglobin drop as the significant parameters which affected MCC and predicted higher grades. The paper's limitations include a low number of cases in the higher Clavien grades and some subgroups of variables, and not applying some techniques due to surgeon preference. Interpretation: Many of the complete supine PCNL complications were in the lower Clavien grades and major complications were uncommon. Renal dysfunction, AUUTA, significant hydronephrosis, tract number, postoperative hemoglobin, and hemoglobin drop were the only factors affecting MCC. IntroductionPresently, percutaneous nephrolithotomy (PCNL) is preferred as a safe and effective way to remove large or multiple upper urinary tract calculi. [1][2][3][4][5][6][7] An increase in PCNL has been accompanied by variations in positions, techniques, and instruments, and these may have led to increased complications.1,2,4,5 Following PCNL, 79.5% of patients may experience an uncomplicated postoperative period, 5,8 although there are reports of an early complication rate of 50.8%. 4PCNL complications may occur during puncturing, access, or stone removal. 4 A standardized classification allow us to compare complications among different instruments, te...

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“…[7] The operation time is a good predictor of the surgical experience and the complexity of the case and is significantly affected by the stone size, location, multiplicity, calyceal anatomy and presence of hydronephrosis. [20] In this study, the impact of surgical experience can be ignored because all of the procedures were performed by a single experienced endourologist. It is also possible to ignore the stone location and multiplicity because these parameters were similar in both groups.…”

Section: Discussionmentioning

confidence: 99%

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

Yürük¹,

Binbay²,

Akman³

et al. 2014

Turkish Journal of Urology

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Objective: Shock-wave lithotripsy (SWL) is the first-line treatment for the active removal of small and medium-sized kidney stones. Flexible ureterorenoscopy (fURS) is recommended after failed SWL treatment. The aim of this retrospective analysis is to evaluate whether prior unsuccessful SWL treatments affect the outcomes of fURS. Material and methods:Data from 206 patients who underwent fURS for the treatment of renal stones between September 2009 and January 2011 were collected, and the patients were divided into two groups according to their previous SWL treatment. The patient demographics, stone characteristics, operation and fluoroscopy times, stone-free rates and complications were compared.Results: Of the patients, 114 (55.3%) did not undergo SWL prior to fURS (Group 1), whereas 92 (44.6%) completed a minimum of 3 sessions of SWL and waited at least 2 weeks before the fURS operation (Group 2). Although the mean stone number was higher in Group 2, this difference was not significant (p= 0.06). The mean operation (p= 0.12) and fluoroscopy times (p= 0.69) were similar between the groups. The mean operation time per mm 2 stone and fluoroscopy time per mm2 stone were not significantly different (p= 0.64 and p= 0.76, respectively). The length of the hospitalization and the overall complication rates were similar. After the third postoperative month, the stone-free rates were not different between the groups (82.5% and 86.9%, respectively, p=0.38). Conclusion:The stone-free and complication rates of fURS were not affected by previous SWL therapy.

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Variables That Influence Operative Time During Percutaneous Nephrolithotomy: An Analysis of 1897 Cases

Abstract: Presence of hydronephrosis, renal stone size and type significantly affect the operative time during PCNL. The duration of the operation was also observed to decrease with increased surgical experience.

Cited by 47 publications

References 23 publications

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Factors affecting complications according to the modified Clavien classification in complete supine percutaneous nephrolithotomy

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

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