Results of percutaneous nephrolithotomy using two accesses in the treatment of patients with staghorn stones
INTRODUCTION: In order to improve clinical efficiency and reduce the risk of postoperative complications in patients with staghorn stones, we compared the results of original technique of biportal percutaneous nephrolithotomy (PCNL) with the standard PCNL.
MATERIALS AND METHODS: The total of 221 patients with staghorn stones of K3-K4 was included in the study. The biportal PCNL was used in 109 patients, while the control group consisted of 112 patients. Inclusion criteria were stone size more or equal 2 cm, age over 18 years, absence of coagulopathy and width of the renal parenchyma more or equal 1 cm. On 1st postoperative day, ultrasound or plain urography was performed, while in patient with radiolucent stones, multi-slice computed tomography was used. In addition, complete blood count and biochemical profile were done. The main difference from the standard PCNL with sequential renal tracts is the simultaneous creation of the main and additional accesses when performing biportal PCNL. This method allowed two surgeons to simultaneously and synergistically perform lithotripsy and stone extraction from two accesses using a standard nephroscope in the main tract of 24 Ch and a miniaturized nephroscope in the additional tract of 16.5 Ch.
RESULTS: The stone-free rate in the group of biportal PCNL was 80.7% (n=88), compared to 72.3% in the control group (n=81). Secondary interventions and additional procedures were required in 29 (26.6%) and 40 (39.2%) cases, respectively. The total number of infectious and hemorrhagic complications was higher in the control group.
DISCUSSION: According to our data, significant advantages are observed in the group of biportal PCNL compared to the standard technique.
CONCLUSION: Biportal PCNL can be recommended as a promising advancement of the technique traditionally used in the clinical practice.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2022 |
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| Enthalten in: |
Urologiia (Moscow, Russia : 1999) - (2022), 1 vom: 15. März, Seite 11-16 |
| Sprache: |
Russisch |
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| Beteiligte Personen: |
Merinov, D S [VerfasserIn] |
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| Themen: |
Clinical Study |
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| Anmerkungen: |
Date Completed 14.03.2022 Date Revised 31.05.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338056734 |
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| 100 | 1 | |a Merinov, D S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Results of percutaneous nephrolithotomy using two accesses in the treatment of patients with staghorn stones |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 14.03.2022 | ||
| 500 | |a Date Revised 31.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: In order to improve clinical efficiency and reduce the risk of postoperative complications in patients with staghorn stones, we compared the results of original technique of biportal percutaneous nephrolithotomy (PCNL) with the standard PCNL | ||
| 520 | |a MATERIALS AND METHODS: The total of 221 patients with staghorn stones of K3-K4 was included in the study. The biportal PCNL was used in 109 patients, while the control group consisted of 112 patients. Inclusion criteria were stone size more or equal 2 cm, age over 18 years, absence of coagulopathy and width of the renal parenchyma more or equal 1 cm. On 1st postoperative day, ultrasound or plain urography was performed, while in patient with radiolucent stones, multi-slice computed tomography was used. In addition, complete blood count and biochemical profile were done. The main difference from the standard PCNL with sequential renal tracts is the simultaneous creation of the main and additional accesses when performing biportal PCNL. This method allowed two surgeons to simultaneously and synergistically perform lithotripsy and stone extraction from two accesses using a standard nephroscope in the main tract of 24 Ch and a miniaturized nephroscope in the additional tract of 16.5 Ch | ||
| 520 | |a RESULTS: The stone-free rate in the group of biportal PCNL was 80.7% (n=88), compared to 72.3% in the control group (n=81). Secondary interventions and additional procedures were required in 29 (26.6%) and 40 (39.2%) cases, respectively. The total number of infectious and hemorrhagic complications was higher in the control group | ||
| 520 | |a DISCUSSION: According to our data, significant advantages are observed in the group of biportal PCNL compared to the standard technique | ||
| 520 | |a CONCLUSION: Biportal PCNL can be recommended as a promising advancement of the technique traditionally used in the clinical practice | ||
| 650 | 4 | |a Clinical Study | |
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a percutaneous nephrolithotomy | |
| 650 | 4 | |a staghorn stones | |
| 650 | 4 | |a urolithiasis | |
| 700 | 1 | |a Kazachenko, A V |e verfasserin |4 aut | |
| 700 | 1 | |a Artemov, A V |e verfasserin |4 aut | |
| 700 | 1 | |a Arustamov, L D |e verfasserin |4 aut | |
| 700 | 1 | |a Gurbanov, S S |e verfasserin |4 aut | |
| 700 | 1 | |a Konstantinova, O V |e verfasserin |4 aut | |
| 700 | 1 | |a Shamkhalova, K K |e verfasserin |4 aut | |
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