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Perioperative and long-term results of ultrasonography-guided single-and multiple-tract percutaneous nephrolithotomy for staghorn calculi

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World Journal of Clinical Cases 2024年第7期12卷 1243-1250页

作者： Rui-Xiang Cheng Ni Dai Yan-Min Wang Pei Qi Fen Chen Department of Urology Wuhan Ninth HospitalWuhan 430081Hubei ProvinceChina Department of Urinary Pain Wuhan Hankou HospitalWuhan 430000Hubei ProvinceChina Pre-hospital Emergency Department Wuhan Puren HospitalWuhan 430081Hubei ProvinceChina Department of Orthopedic Trauma Surgery Wuhan Hankou HospitalWuhan 430000Hubei ProvinceChina Department of Ultrasound Hubei Provincial Hospital of Integrated Traditional Chinese and Western MedicineWuhan 430015Hubei ProvinceChina

BACKGROUND It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention.Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy(MPCNL)has a similar stone free rate(SFR)as standard percutaneous nephrolithotomy(S-PCNL).As a result,M-PCNL was also recommended as a treatment option for staghorn calculi.AIM To examine the perioperative and long-term results of ultrasonography-guided single-and M-PCNL.METHODS This was a retrospective cohort study.Between March 2021 and January 2022,the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy.The primary outcomes were com plication rate and SFR,and the characteristics of patients,operative parameters,laboratory measurements were also collected.RESULTS In total,345 patients were enrolled in the study(186 in the S-PCNL group and 159 in the M-PCNL group).The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group(P=0.033).Moreover,the incidence rates of hydrothorax(P=0.03)and postoperative infection(P=0.012)were higher in the M-PCNL group than in the S-PCNL group.Logistic regression analysis demonstrated that post-operative white blood cell count(OR=2.57,95%CI:1.90-3.47,P<0.001)and stone size(OR=1.59,95%CI:1.27-2.00,P<0.001)were associated with a higher overall complication rate in the S-PCNL group.Body mass index(OR=1.22,95%CI:1.06-1.40,P=0.004)and stone size(OR=1.70,95%CI:1.35-2.15,P<0.001)were associated with increased overall complications in the M-PCNL group.CONCLUSION Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.

关键词： Single-tract percutaneous nephrolithotomy Multiple-tract percutaneous nephrolithotomy staghorn calculi Ultrasonography

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The role of ureteroscopy for treatment of staghorn calculi: A systematic review

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Asian Journal of Urology 2020年第2期7卷 110-115页

作者： Etienne Xavier Keller Vincent De Coninck Steeve Doizi Olivier Traxer Sorbonne Universite Service d’UrologieAP-HPHopital TenonF-75020ParisFrance Sorbonne Universite GRC n°20Groupe de Recherche Clinique sur la Lithiase UrinaireHopital TenonF-75020ParisFrance Department of Urology University Hospital ZurichUniversity of ZurichZurichSwitzerland Department of Urology AZ KlinaBrasschaatBelgium

Objective:To define the role of ureteroscopy for treatment of staghorn calculi.Methods:A systematic review was conducted using the Scopus and Medline databases.Original articles and systematic reviews were selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Only studies relating to the role of ureteroscopy for treatment of staghorn calculi were included.Results:In five studies on ureteroscopic monotherapy,stone-free rate(SFR)ranged from 33%to 93%,with a maximum four ureteroscopy sessions per patient and no major complications.Endoscopic combined intrarenal surgery(ECIRS)was compared with percutaneous nephrolithotomy(PNL)in two studies and reached significantly higher SFR(88%e91%vs.59%e65%)and lower operative times(84e110 min vs.105e129 min).The role of salvage ureteroscopy for residual stones after primary PNL has been highlighted by two studies with a final SFR of 83%e89%.One study reported on the feasibility of ureteroscopy for ureteral stones and same-session PNL for contralateral staghorn calculi,with a SFR of 92%.Conclusion:Ureteroscopy plays a pivotal role in the setting of a combined approach to staghorn calculi.Ureteroscopy is also particularly suitable for clearance of residual stones.In specific cases,ureteroscopy may become the sole applicable therapeutic option to staghorn calculi.Technological advances and refinement of techniques suggest a major role of ureteroscopy for staghorn calculi treatment in close future.

关键词： staghorn calculi Ureteroscopy Percutaneous nephrolithotomy Combined approach Intrarenal surgery Simultaneous bilateral endoscopic surgery

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Minimally invasive percutaneous nephrolithotomy for staghorn calcull:A novel single session approach via multi-tracts

Minimally invasive percutaneous nephrolithotomy for staghorn...

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第六次全国中西医结合泌尿外科学术会议暨第二届湖南省中西...

作者：曾国华钟文李逊陈文忠杨后猛广州医学院第一附属医院微创外科中心泌尿外科

Introduction and objective:Many urologists hesitate to place more than 2-3 tracts during PCNL because of the belief that this may increase complications.Using a smaller-size percutaneous tract than conventional PCNL,minimally invasive percutaneous nephrolithotomy (MPCNL) has the potential advantage of decreased bleeding and trauma while disadvantages of a longer operative time,it’s not recommended for stones greater than 2cm in diameter generally.During the practice of MPCNL,we have a novel impulsive stream with high pressure produced by MCC Pump to facility removing the fragment of calculi,which accelerated the operative course.In this series,we reported our experience of MPCNL within multiple 14-18Fr percutaneous tracts to treat staghorn calculi in a single session procedure,evaluated the feasibility and efficiency of this technique.

关键词： calculi staghorn calculi Lithotripsy Percutaneous Percutaneous Nephrolithotomy PCNL

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