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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

Metabolic evaluation and medical management of staghorn calculi

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Asian Journal of Urology 2020年第2期7卷 122-129页

作者： Russell STerry Glenn M.Preminger Duke Comprehensive Kidney Stone Center Division of Urologic SurgeryDuke University Medical CenterDurhamNCUSA

staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting *** may be composed of metabolic or infection stone *** are often associated with specific metabolic *** stones are associated with urease-producing bacterial urinary tract *** ideal treatment for staghorn calculi is maximal surgical ***,some patients are either unwilling or unable to proceed with that modality of treatment,and therefore other management must be *** such technique is the metabolic evaluation with directed medical *** on contemporary evidence that the majority of staghorn stones are metabolic in etiology,and furthermore that even infection stones are usually associated with metabolic abnormalities,metabolic evaluation with directed medical management is recommended for all staghorn stone *** scientific basis of this recommendation is reviewed in the present work.

关键词： Urolithiasis staghorn Metabolic evaluation Struvite

Morphometry scores: Clinical implications in the management of staghorn calculi

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Asian Journal of Urology 2020年第2期7卷 78-86页

作者： Jared S.Winoker Ryan A.Chandhoke William Atallah Mantu Gupta Department of Urology Icahn School of Medicine at Mount SinaiNew YorkNYUSA

Due to their large size,rapid growth,and attendant morbidity,staghorn calculi are complex clinical entities that impose significant treatment-related ***,their relative heterogeneitydin terms of both total stone burden and anatomic distributiondlimits the ability to standardize their characterization and the reporting of surgical *** morphometry systems currently exist to define the volumetric distribution of renal stones,in general,and to predict the outcomes of percutaneous nephrolithotomy;however,they fall short in their applicability to staghorn *** this review,we aim to discuss the clinical utility of morphometry systems and the influence of pelvicalyceal anatomy on the management of these complex calculi.

关键词： Nephrolithiasis Percutaneous nephrolithotomy staghorn Kidney stone Morphometry

Definition, treatment and outcome of residual fragments in staghorn stones

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Asian Journal of Urology 2020年第2期7卷 116-121页

作者： Osman Ermis Bhaskar Somani Thomas Reeves Selcuk Guven Pilar Laguna Pes Arun Chawla Padmaraj Hegde Jean de la Rosette Istanbul Medipol University School of MedicineDepartment of UrologyIstanbulTurkey University Hospital Southampton NHS Trust Department of UrologySouthamptonUK Kasturba Medical College Manipal Academy of Higher EducationDepartment of UrologyManipalIndia

Technological advances in minimally invasive treatment of stone disease and its integration with concomitant clinical practice are amongst the most important achievements in *** the wealth of information accumulated over the years and the richness of existing literature,the knowledge about the definition,treatment and outcomes of residual stone fragments after percutaneous nephrolithotomy(PNL)is still *** to the high stone load a lot of patients with staghorn stones have residual fragments(RFs)after treatment with PNL,which depends on the size of tract,definition of stone free rate(SFR),timing of evaluation and the imaging *** consensus exists on the imaging modality or their timing in the evaluation of possible *** treatment of residual stones is apparently different depending on the facilities of the department and the preference of the surgeon,which includes active surveillance,shock wave lithotripsy(SWL),retrograde intrarenal surgery(RIRS)or a second look PNL.

关键词： Urolithiasis Stone management staghorn Percutaneous nephrolithotomy Residual fragments staghorn stones

Balloon dilation versus Amplatz dilation during ultrasound-guidedpercutaneous nephrolithotomy for staghorn stones

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Chinese Medical Journal 2014年第6期127卷 1057-1061页

作者： Minghua Ren Cheng Zhang Weijun Fu Yiming Fu Li Ma Weiming Zhao Wanhai Xu Shaobin Ni Department of Urinary Surgery First Affiliated Hospital Harbin Medical University Harbin Heilongjiang 150001 China. Department of Urinary Surgery Chinese People's Liberation Army General Hospital Beijing 100853 China. Department of Urinary Surgery Fourth Affiliated Hospital Harbin Medical University Harbin Heilongjiang 150001 China. Email: xuwanhai@***. Department of Urinary Surgery First Affiliated Hospital Harbin Medical University Harbin Heilongjiang 150001 China. Email: urologydepartment2@***.

Background Amplatz dilation and balloon dilation are different methods in creating the accesses during percutaneous nephrolithotomy(PCNL). The aim of this study was to review the surgical experiences of managing staghorn calculi by Amplatz dilation and balloon dilation for 3 *** We retrospectively analyzed clinical data from 125 patients(129 kidneys) with staghorn kidney stones who underwent PCNL from January 2010 to December 2012, of whom 60 patients underwent Amplatz dilation(AD group) and 65 underwent balloon dilation(BD group) during *** The AD and BD groups were similar in age, male–female ratio, stone burden, stone type, hydronephrosis, and proportion of patients who had undergone extracorporeal lithotripsy. However, these two groups showed significant differences in terms of duration of percutaneous access(15.1±3.6) minutes vs.(10.0±3.3) minutes, one-attempt success rate of dilation via a single access 88.9%(72/81) vs. 97.8%(91/93), hemoglobin drop after surgery(3.5±0.9) g/dl vs.(1.7±0.9) g/dl, number of cases requiring intraoperative and postoperative blood transfusion 27.9%(n=17) vs. 13.2%(n=9), changes of central venous pressure before and after surgery(2.3±1.2) cmH2 O vs.(1.2±0.7) cmH2 O, number of patients who experienced postoperative fever >37.5°C 21(34.4%) vs. 13(19.1%)(all P staghorn stones, balloon dilation and Amplatz dilation are all effective and safe. Compared with Amplatz dilation, balloon dilation is a better choice, as it has a higher access creation success rate, shorter access creation time less blood loss, and lower proportions of circulatory overload and postoperative fever.

关键词： percutaneous nephrolithotomy staghorn stones ultrasound balloon dilation Amplatz dilation

A Novel Semi-rigid Nephroscope Percutaneous Nephrolithotomy： The Best Therapy for Renal staghorn Calculi

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Chinese Medical Journal 2015年第22期128卷 3109-3111页

作者： Bo Xiao Song Chen Xin Zhang Wei-Guo Hu Yu-Bao Liu Yu-Zhe Tang Jian-Xing Li Department of Urology Beijing Tsinghua Changgung Hospital Medical Center Tsinghua University Beijing 102218 China

Percutaneous nephrolithotomy （PCNL） has been the first-line treatment for renal staghorn calculi for many years. Several techniques have been described for percutaneous access and stone removal, but a multi-access approach is the mainstay of treatment. The main concern about PCNL is the resultant morbidity： Complications such as bleeding, parenchymal damage, and organ injury hindered the adoption of PCNL in primary hospitals in China.

关键词： Kidney Percutaneous Nephrolithotomy Semi-rigid staghorn

Recurrent Sinonasal Hemangiopericytoma: A Rare Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第1期9卷 14-18页

作者： Worood Husain Mahran Kazerooni Ahmed Jamal Department of ENT Head and Neck Surgery Salmaniya Medical Complex Manama Kingdom of Bahrain

Hemangiopericytoma (HPC) is a rare vascular tumor arising from capillary pericytes. This tumor represents 3% - 5% of all soft tissue sarcomas and 1% of all vascular tumors. Only 15% - 30% of cases occur in the head and neck region, among which sinonasal hemangiopericytoma (HPC) is accounted for around 5% of cases. Hemangiopericytoma (HPC) has a tendency for recurrence. Here, a case of recurrent nasal hemangiopericytoma (HPC) after 12 years of treatment is reported.

关键词： Hemangiopericytoma Sinonasal Hemangiopericytoma Endoscopic Approach staghorn Pattern

Chest Wall Hemangiopericytoma-Like Solitary Fibrous Tumor of the Pleura: Case Report with Computed Tomography Findings

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Advances in Computed Tomography 2013年第4期2卷 129-131页

作者： Motohisa Kuwahara Hiroshi Nishimura Masato Iwami Kazuya Naritomi Masae Mano Koji Inutsuka Keita Tokuishi Akinori Iwasaki Department of Chest Surgery Fukuoka University Hospital Fukuoka Japan Division of Surgery Saiseikai Futukaichi Hospital Fukuoka Japan

We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma.

关键词： Solitary Fibrous Tumor Hemangiopericytoma staghorn Vessels

The Role of Imaging in Diagnosis of Urolithiasis and Nephrolithiasis—A Literature Review Article

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Yangtze Medicine 2019年第4期3卷 301-312页

作者： Abhinandan Gupta Sheng Li Guanghai Ji Hao Xiong Jie Peng Jingbai Huang Department of Medical Imaging and Nuclear Medicine The First Affiliated Peoples Hospital of Jing Zhou Yangtze University Jingzhou China

Urolithiasis or nephrolithiasis is a common ailment in the emergency room. The clinical presentation of a kidney stone includes fever, nausea, vomiting, acute flank pain radiating to the groin or the back. The pain is often described as stabbing and there is tachycardia, with or without hematuria for the severe patient. For the triad for urinary or kidney stones, some people say they are fever, vomiting, and acute flank pain. So in acute setting analgesia is given with or without an antiemetic to prevent vomiting IV fluids administered carefully. Noncontrast computed tomography (CT) is the gold standard for diagnosis. Most of urinary stones get washouts spontaneously if it is less than 5 mm without any intervention. However, if intervention is required either it is done by elective or as soon as possible by the intervention. I mean surgical management and surgical management will depend on how big the kidney stone is in there as well as where the kidney stone is if it is within the ureter or within the actual kidney.

关键词： Urolithiasis Nephrolithiasis Kidney Stone staghorn Calculus Ultrasound X-Ray CT MRI Shockwave Lithotripsy