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The global,prevalence,and risk factors of postoperative fever after percutaneous nephrolithotomy:A systematic review and meta-analysis

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Asian Journal of Urology 2024年第2期11卷 253-260页

作者： Reza Falahatkar Siavash Falahatkar Mohammad Amin Khajavi Gaskarei Masoomeh Afzalipoor Ali Mojtahedi Neda Aligolighasemabadi Ahmad Deilami Samaneh Mirzaei Dahka Mohammad-Hossein Keivanlou Alireza Jafari Urology Research Center Guilan University of Medical SciencesGuilanRashtIran Department of Surgery University of SaskatchewanSaskatoonCanada Microbiology Department School of MedicineGuilan University of Medical SciencesRashtIran Department of Internal Medicine School of MedicineGuilan University of Medical SiencesRashtIran School of Nursing and Midwifery Guilan University of Medical SciencesGuilanRashtIran

Objective:This study aimed to explore the global,prevalence,and risk factors of fever after percutaneous nephrolithotomy(PCNL)by conducting a systematic review and ***:The high-sensitivity searching was conducted without time limitation until December 30,2020 in Web of Sciences,Scopus,and PubMed based on inclusion and exclusion ***:The prevalence rates of fever and sepsis among patient undergoing PCNL were estimated 9.5%(95%confidence interval[CI]:9.3%-9.7%),and 4.5%(95%CI:4.2%-4.8%),*** tube was used in 9.96%(95%CI:9.94%-9.97%)of *** mean preoperative white blood cells of patients were 6.401×109/L;18.3%and 4.55%of patients were considered as the positive urinary culture and pyuria,*** 20.4%of patients suffered from residual *** odds ratios(ORs)of fever in patients who suffering from diabetes mellitus,hydronephrosis,staghorn stones,and blood transfusion were 4.62(95%CI:2.95-7.26),1.04(95%CI:0.81-1.34),2.57(95%CI:0.93-7.11),and 2.65(95%CI:1.62-4.35),*** who underwent PCNL in prone position were more likely to develop fever(OR:1.23;95%CI:0.75-2.00)than patients in supine ***:The current study showed that patients who suffer from diabetes mellitus,hydronephrosis,staghorn stones,nephrostomy tube or double-J stent,blood transfusion,and also patients who underwent PCNL in prone position surgery are more likely to develop a postoperative fever after PCNL.

关键词： percutaneous nephrolithotomy Fever Hydronephrosis Diabetes Meta-analysis

Predictive factors for percutaneous nephrolithotomy bleeding risks

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Asian Journal of Urology 2024年第1期11卷 105-109页

作者： U Phun Loo Chun Hou Yong Guan Chou Teh Urology Department Sarawak General HospitalKuchingMalaysia

Objective:This study aimed to identify predictive factors for percutaneous nephrolithotomy(PCNL)bleeding *** better risk stratification,bleeding in high-risk patient can be anticipated and facilitates early ***:A prospective observational study of PCNL performed at our institution was *** adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy,planned for additional *** including gender,co-morbidities,body mass index,stone burden,puncture site,tract dilatation size,operative position,surgeon's seniority,and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin(Hb)***:Overall,4.86%patients(n=7)received packed cells *** mean estimated Hb deficiency was 1.3(range 0-6.5)g/dL and the median was 1.0 g/*** multivariate regression analysis revealed that absence of hypertension(p=0.024),puncture site(p=0.027),and operative duration(p=0.023)were significantly associated with higher estimated Hb ***,the effect sizes are rather small with partial eta-squared of 0.037,0.066,and 0.038,*** power obtained was 0.621,0.722,and 0.625,*** factors studied did not correlate with Hb ***:Hypertension,puncture site,and operative duration have significant impact on estimated Hb deficiency during ***,the effect size is rather small despite adequate study power ***,operative position(supine or prone),puncture number,or tract dilatation size did not correlate with Hb *** mainstay of reducing bleeding in PCNL is still meticulous operative *** study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient,without increasing risk of bleeding.

关键词： percutaneous nephrolithotomy Predictive factor Risk factor Bleeding Blood loss

Clinical efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for large kidney stones:A retrospective comparative study

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World Journal of Clinical Cases 2024年第21期12卷 4483-4490页

作者： Qiu-Lian Wang Jun-Qiang Liu Juan Cao Jun Ding Department of Urology No.904 Hospital of Joint Logistic Support Force of PLAWuxi 214044Jiangsu ProvinceChina

BACKGROUND Renal stones ranging 20–40 mm are very common in *** no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional *** To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,*** 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical *** FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous *** operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two *** and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also *** All 250 eligible patients completed the *** were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL *** time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL *** FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative *** was no significant difference in antibiotic use between the *** serum

关键词： Kidney stones Flexible ureteroscopy percutaneous nephrolithotomy Clinical effective SCM-1 Erythrocyte sedimentation rate Kidney injury molecule 1

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 in octogenarians and beyond:How old is too old?

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Asian Journal of Urology 2015年第4期2卷 208-213页

作者： Bradley Morganstern Riccardo Galli Piruz Motamedinia David Leavitt Mohamed Keheila Eric Ghiraldi David Hoenig Arthur Smith Zeph Okeke The Smith Institute for Urology NorthShore-Long Island Jewish Health SystemNew Hyde ParkNYUSA

Objective:To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy(PCNL).PCNL has been established as feasible in the elderly;however,to our knowledge no one has specifically reported feasibility in patients 80 years and ***:We retrospectively reviewed perioperative data of octogenarians who underwent PCNL at a high stone volume single institution,and matched them to patients<65 years of age by stone burden and *** demographics,perioperative outcomes and postoperative complications were ***:Thirty-three octogenarians(mean age 83.6 years)with 36 renal units were matched to 67 controls(mean age 48.6 years)with 72 renal *** had a higher mean American Society of Anesthesiologists(ASA)score,more comorbidities,and worse renal *** were no differences in operative characteristics,length of hospital stay or stone free *** the patients with preoperative urinary decompression(ureteral stent or nephrostomy tube)prior to PCNL,the elderly were more likely to have a history of *** did not experience more minor Clavien(Ⅰ-Ⅱ)or major Clavien(Ⅲa-Ⅳb)***:Octogenarians who undergo PCNL were more likely to have cardiovascular comorbidities and a prior history of *** these risk factors,in appropriately selected patients PCNL can be safely and successfully performed in octogenarians without increased perioperative complications relative to a younger cohort.

关键词： percutaneous nephrolithotomy Elderly percutaneous stone extraction complications Clavien Octogenarians percutaneous stone extraction

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

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

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