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percutaneous nephrolithotomy for staghorn calculi: Troubleshooting and managing complications

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Asian Journal of Urology 2020年第2期7卷 139-148页

作者： Nariman Gadzhiev Vigen Malkhasyan Gagik Akopyan Sergei Petrov Francis Jefferson Zhamshid Okhunov Department of Urology Pavlov First Saint Petersburg State Medical UniversityRussia Institute for Urology and Reproductive Health Sechenov UniversityMoscowRussia Department of Urology Sechenov First Moscow State Medical UniversityRussia Department of Urology University of CaliforniaOaklandCAUSA

Staghorn calculi comprise a unique subset of complex kidney stone disease. percutaneousnephrolithotomy (PCNL) is the gold standard treatment for staghorn stones. Despitecontinuous refinements to the technique and instrumentation of PCNL, these stones remaina troublesome challenge for endourologists and are associated with a higher rate of perioperativecomplications than that for non-staghorn stones. Common and notable intraoperativecomplications include bleeding, renal collecting system injury, injury of visceral organs, pulmonarycomplications, thromboembolic complications, extrarenal stone migration, andmisplacement of the nephrostomy tube. Postoperative complications include infection and urosepsis,bleeding, persistent nephrocutaneous urine leakage, infundibular stenosis, and *** this review, we report recommendations regarding troubleshooting measures that can beused to identify and characterize these complications. Additionally, we include informationregarding management strategies for complications associated with PCNL for staghorn calculi.

关键词： percutaneous nephrolithotomy Staghorn Complications Management Urolithiasis

percutaneous nephrolithotomy and laparoscopic surgery efficacy and renal function outcomes for large and complex renal calculi

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Current Urology 2024年第4期18卷 268-272页

作者： Yuriy Pak Nina Kalyagina Daniel Yagudaev CUC City Multidisciplinary Hospital No.2 City Center of UrologyNur-SultanKazakhstan Prokhorov General Physics Institute of the Russian Academy of Sciences MoscowRussia National Research Nuclear University MEPhI MoscowRussia Peoples’Friendship University of Russia(RUDN University) MoscowRussia Central Clinical Hospital Russian Railways-MedicineMoscowRussia

Background There is limited published evidence regarding the incidence of intraoperative and postoperative events and the effect of percutaneous nephrolithotomy(PCNL)in supine and prone positions and laparoscopic pyelolithotomy on kidney function in patients with large and complex *** and methods We evaluated the surgical outcomes of 97 patients with large and complex kidney *** patients were divided into 3 groups:those who underwent PCNL in the prone position,PCNL in the supine position,and pyelolithotomy by laparoscopy and *** surgical outcomes,size of residual stones,stone-free rate,glomerular filtration rate(GFR),and split GFR obtained from Tc-99m renal dynamic scintigrams were *** percutaneous nephrolithotomy in the prone position was correlated with improved function of the affected *** the supine PCNL group,none of the analyzed indicators demonstrated a significant *** nephroscintigrams revealed negative changes in terms of accumulation and secretion of the affected kidney.A slight decrease in creatinine clearance was ***,positive dynamics in split GFR and secretory index were seen in this *** laparoscopic group showed positive results in all analyzed ***,full assessment of the function of the affected kidney in this group was limited due to restricted use of laparoscopic pyelolithotomy for complex *** percutaneous nephrolithotomy in the prone position resulted in the most favorable renal functional outcomes for patients with high-grade renal calculi,whereas a laparoscopic approach may be preferred for patients with stones of lower *** most significant factors that adversely affected renal function were intraoperative bleeding volume,kidney stone size and density,and body mass index.

关键词： Dynamic nephroscintigraphy Large and complex renal calculi Lithotripsy percutaneous nephrolithotomy Prone and supine positions Renal function

Clinical study on the minimally invasive percutaneous nephrolithotomy treatment of upper urinary calculi

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World Journal of Clinical Cases 2022年第4期10卷 1198-1205页

作者： Xiao-Jian Xu Jun Zhang Miao Li Jian-Quan Hou Department of Urology The First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina

BACKGROUND Upper urinary tract stones are very common in my country,with an incidence of 1%to 5%in the North and an even higher incidence of 5%to 10%in the *** incidence rate in the south is higher than that in the north,mainly due to the water quality,climate and eating habits of the *** the perspective of sex,incidence is more likely in males than *** the high-incidence population,young adults are most prone to *** in the age range of 25 to 40 years are more likely to have *** To observe the therapeutic effect of minimally invasive percutaneous nephrolithotomy(mPCNL)on upper urinary tract stones and its influence on the renal function of *** Patients with upper urinary tract stones who were treated in our hospital from February 2017 to March 2018 were selected as research subjects and were divided into the PCNL group and the mPCNL group according to the random number table *** general conditions of the two groups of patients were observed during the perioperative period,and the differences in stone clearance,pain,renal function indicators and complication rates were compared between the two groups to determine which were statistically significant(P<0.05).RESULTS The operation time of the mPCNL group was longer than that of the PCNL group(t=-34.392,P<0.001),and the intraoperative blood loss of the mPCNL group was more than that of the PCNL group(t=34.090,P<0.001).There was no difference in renal function indices between the two groups of patients before treatment,and there was no difference in the levels of serum creatinine,β2 microglobulin or retinol binding protein in the mPCNL group after *** visual analog scale score of patients in the mPCNL group was lower than that of the PCNL group(t=12.191,P<0.001),and there was no significant difference in the stone clearance rate between the two groups(χ2 value=1.013,P=0.314).There was no significant difference in the incidence of urine extravasation,dyspnea

关键词： percutaneous nephrolithotomy Minimally invasive percutaneous nephrolithotomy Upper urinary calculi Calculi Renal function Complications

Lingual nerve injury caused by laryngeal mask airway during percutaneous nephrolithotomy:A case report

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World Journal of Clinical Cases 2021年第35期9卷 11095-11101页

作者： Zheng-Yi Wang Wan-Zhang Liu Feng-Qi Wang Ying-Zhi Chen Ting Huang He-Sheng Yuan Yue Cheng Medical College Ningbo UniversityNingbo 315211Zhejiang ProvinceChina Department of Urology Ningbo First HospitalThe Affiliated Hospital of Ningbo UniversityNingbo 315010Zhejiang ProvinceChina

BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of *** present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back *** computed tomography showed a 25 mm×20 mm stone in the left renal *** surgery using LMA was performed to remove the renal *** patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or *** patient was diagnosed with LNI after other possible causes were ruled *** symptom of numbness eventually improved after conservative medical therapy for 1 *** patient completely recovered 3 wk after *** This is the first case report describing LNI with the use of LMA in *** our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.

关键词： Lingual nerve injury Laryngeal mask airway percutaneous nephrolithotomy Case report

Ultrasonography-guided percutaneous nephrolithotomy with Chinese One-shot Tract Dilation Technique Based on Stimulated Diuresis:A Report of 67 Cases

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 881-886页

作者： Ying SHI Hua-geng LIANG Xiong YANG Bo HAI Liang WANG Yi-fei XING Wen JU Fu-qing ZENG Xiao-ping ZHANG Wen-cheng LI Department of Urology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China

The safety and effectiveness of a novel Chinese one-shot dilation technique based on stimulated diuresis for percutaneous nephrolithotomy（PCNL） were *** the feasibility of the Chinese one-shot dilation based on stimulated diuresis was verified by an animal study,this technique was applied in the clinical practice.A total of 67 patients in our department underwent the modified PCNL from July 2014 to June *** the renal infundibulum was distended by stimulated diuresis,the kidney was punctured under the ultrasonographic guidance via the fornix of the target *** working channel was dilated using a special designed pencil-shaped fascial *** successful access rate,nephrostomy tract creation time,pre-and postoperative hemoglobin values and serum creatinine concentrations,stone-free rate and complications were recorded and *** renal infundibulum was successfully distended in all of the patients by the diuresis *** the ultrasonographic guidance,the successful access rate was 100% and the mean tract creation time was 2.0 min（range：1.5–5.0 min）.The stone-free rate right after surgery was 91.0%.Although the postoperative hemoglobin was significantly reduced（P〈0.01）,transfusion was not clinically *** was no significant difference in serum creatinine concentrations before and after operation（P〉0.05）.No severe complication occurred during or after the *** was suggested that this Chinese one-shot dilation technique based on stimulated diuresis is an efficient and safe innovation for PCNL,and is even helpful for those patients with non-dilated pelvicaliceal systems.

关键词： percutaneous nephrolithotomy dilation stimulated diuresis ultrasonography

Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy:A controlled study

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World Journal of Clinical Cases 2022年第18期10卷 6039-6049页

作者： Fei Qin Ye-Feng Sun Xin-Ning Wang Bin Li Zhi-Lei Zhang Ming-Xin Zhang Fei Xie Shuai-Hong Liu Zi-Jie Wang Yuan-Chao Cao Wei Jiao Department of Urology The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent *** techniques are required to assist in planning and *** To apply and evaluate the Hisense computer-assisted surgery(CAS)system in *** A total of 60 patients with complex renal stones were *** patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS *** model assisted in planning and navigating in the CAS *** patients in the control group planned and navigated as standard PCNL,without the application of the CAS *** rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and *** There were no statistically significant differences in the baseline characteristics or planning *** success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS ***,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control *** statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were *** Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free *** Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.

关键词： Computer-assisted surgery system percutaneous nephrolithotomy Three-dimensional reconstruction Planning Navigation

Bleeding of two lumbar arteries caused by one puncture following percutaneous nephrolithotomy:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5790-5794页

作者： Qian Liu Chuan Yang Kai Lin Dong Yang Tumor and Interventional Radiology Hanchuan People’s HospitalHanchuan 432300Hubei ProvinceChina Urology Hanchuan People’s HospitalHanchuan 432300Hubei ProvinceChina Interventional Radiology Hanchuan People’s HospitalHanchuan 432300Hubei ProvinceChina

BACKGROUND Lumbar artery bleeding is an uncommon complication of percutaneous nephrolithotomy(PCNL).This report presents a rare complication where two lumbar arteries were injured by a single puncture following *** scarce reports of this complication have been *** SUMMARY A 24-year-old man presented with a 2.2 cm right renal calculus,which was managed by *** nephrostomy tube removal on the 6th postoperative day,intense bleeding was observed in the fistula and the *** angiography was undertaken immediately;however,an initial selective renal angiogram revealed no evidence of renal vascular *** of these injuries involved a pseudoaneurysm from a peripheral branch in the first right lumbar artery,while the other involved an arteriovenous fistula from a peripheral branch in the second right lumbar ***,coil embolization was performed *** This case is being reported to inform clinicians that lumbar artery damage is one of the causes of severe bleeding after PCNL and could involve damage of more than one artery.

关键词： percutaneous nephrolithotomy Lumbar artery Pseudoaneurysm Arteriovenous fistula Embolization Case report

percutaneous nephrolithotomy in pediatric age group:Assessment of effectiveness and complications

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World Journal of Nephrology 2016年第1期5卷 84-89页

作者： Ender Ozden Mehmet Necmettin Mercimek Department of Urology Faculty of Medicine Ondokuz Mayis University Department of Urology Faculty of Medicine Sanko University

Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy(mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones.

关键词： percutaneous nephrolithotomy Pediatric Kidney stone Urolithiasis

Stone-scoring systems for predicting complications in percutaneous nephrolithotomy:A systematic review of the literature

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Asian Journal of Urology 2023年第3期10卷 226-238页

作者： Giorgio Mazzon Simon Choong Antonio Celia Department of Urology AULSS7 PedemontanaSan Bassiano HospitalBassano Del GrappaItaly Institute of Urology University College Hospitals of LondonLondonUK

Objective:percutaneous nephrolithotomy is a treatment of choice for larger stones of the upper urinary ***,several nephrolithometric nomograms for prediction of post-operative surgical outcomes have been proposed,although uncertainties still exist regarding their roles in the estimation of ***:We conducted a systematic review on PubMed and Web of Sciences databases including English studies with at least 100 cases and published between January 2010 and December *** identified original articles evaluating correlations between the Guy’s stone score,the stone size(S),tract length(T),obstruction(O),number of involved calices(N),and essence or stone density(E)(S.T.O.N.E.),Clinical Research Office of the Endourological Society(CROES),and Seoul National University Renal Stone Complexity(S-ReSC)scores and post-operative complications in adult *** also included newly designed nomograms for prediction of specific ***:After an initial search of 549 abstracts,we finally included a total of 18 *** them,11 investigated traditional nephrolithometric nomograms,while seven newly designed nomograms were used to predict specific ***,7316 patients have been *** total,14 out of 18 papers are derived from retrospective single-center ***’s stone score obtained correlation with complications in five,*** score in four,while CROES score and S-ReSC score in three and two,*** of the studies investigated minimally invasive percutaneous nephrolithotomy(PCNL)and all cases have been conducted in prone *** newly designed nomograms,none of them is currently externally validated;five of them predict post-operative infections;the remaining two have been designed for thromboembolic events and urinary ***:This review presents all nomograms currently available in the PCNL field and highlights a certain number of *** data ha

关键词： percutaneous nephrolithotomy Complications Nomogram Stone-scoring system Clavien-Dindo