Vacuum-assisted access sheath in supine mini-percutaneous nephrolithotomy (mini-PCNL).

Autor: Szczesniewski JJ; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain. Electronic address: juliusz.szcz@gmail.com., Boronat Catalá J; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., García-Cano Fernández AM; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., Rodríguez Castro PM; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., Torres Pérez D; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain., Llanes González L; Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2023 Dec; Vol. 47 (10), pp. 681-687. Date of Electronic Publication: 2023 Jun 22.
DOI: 10.1016/j.acuroe.2023.06.004
Abstrakt: Introduction: The vacuum-assisted access sheath is a new device for the treatment of kidney stones with percutaneous nephrolithotomy (PCNL).
Objective: Our aim was to compare the stone-free rate (SFR) and complications between standard mini percutaneous nephrolithotomy (Mini-PCNL) and vacuum-assisted PCNL (Va-PCNL).
Methods: Retrospective study of patients undergoing Mini-PCNL and Va-PCNL from January 2018 to June 2022. Va-PCNL was performed with a disposable sheath (ClearPetra®) with continuous high-flow irrigation and vacuum fluid dynamics for easier stone fragment removal. Baseline patient characteristics, surgical outcomes, perioperative and postoperative data were collected. We compared SFR and complications.
Results: A total of 136 patients were identified, 57 (41,9%) underwent Va-PCNL and 79 (58,15%) Mini-PCNL. Mean operative time was significantly shorter in the Va-PCNL group (95 min.) than in Mini-PCNL (146 min; P = ,001) group. The tubeless technique was performed more frequently in Va-PCNL group (61,4% vs. 34,2%; P = ,002). We did not observe any differences in postoperative complications. The mean hospital stay was significantly lower in Va-PCNL with 1,7 ± 1,9 days per patient compared with 2,7 ± 1,5 days in the Mini-PCNL group (P = ,001). There were no differences in SFR at 3 months between Va-PCNL (71,9%) and Mini-PCNL (71,8%; P =v ,848).
Conclusion: Patients treated with Va-PCNL had comparable results to Mini-PCNL, showing equal SFR with similar infectious complications rates. Potential benefits of Va-PCNL include shorter operative time and postoperative stay.
(Copyright © 2023 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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