Assessment of lower calyceal single-access percutaneous nephrolithotomy for staghorn stones: A single-surgeon and a single-center experience at KAMC, Riyadh
Autor: | Abdulmalik Addar, Ibrahim Sami Abunohaiah, Ahmed Aljuhayman, Muneera Yousef Alkhashan, Yahya Ghazwani |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Percutaneous Urology medicine.medical_treatment Perforation (oil well) 030232 urology & nephrology Lithotripsy lcsh:RC870-923 Single Center 03 medical and health sciences 0302 clinical medicine medicine percutaneous nephrolithotomy Percutaneous nephrolithotomy business.industry renal stone lcsh:Diseases of the genitourinary system. Urology medicine.disease Surgery medicine.anatomical_structure Pneumothorax 030220 oncology & carcinogenesis Original Article business Renal pelvis Kidney disease |
Zdroj: | Urology Annals Urology Annals, Vol 11, Iss 1, Pp 62-65 (2019) |
ISSN: | 0974-7834 0974-7796 |
Popis: | Introduction: Percutaneous nephrolithotomy (PCNL) is still the mainstay and the treatment of choice for most complex renal stones. The success of PCNL is defined by achieving a stone-free rate (SFR). Lower calyceal access PCNL is established to be the safest percutaneous access to the renal system, but controversy is present when it comes to SFR in comparison to upper calyceal and middle calyceal accesses. Aim: We aim to prove that lower calyceal access PCNL is the safest PCNL access and has the same efficacy as upper calyceal access PCNL for staghorn stones. Methodology: All lower calyceal access PCNLs done from May 2012 to August 2017 were included in the study. Postoperative complications were reported using the modified Clavien Grading System. Results: Sixty-seven patients were included in the study. The mean age was found to be 49.39 years; most (36 [53.73%]) patients were male. The prevalence of diabetes, hypertension, dyslipidemia, and chronic kidney disease was 40.91%, 47.76%, 37.31%, and 20.00%, respectively. The mean hospital stay was 7.9 days; mean operative time was 138.52 min. The mean staghorn stone burden was 476.34 mm2. About 80.59% (n = 54) of patients had complete stone resolution after the first session. Only 3 (4.47%) patients had complications and classified as Grade 2 on the modified Clavien Grading System and the remainder were classified as Grade 1, two patients needed postoperative blood transfusion, and one had a renal pelvis perforation. Conclusion: When it comes to safety and efficacy, the use of lower calyceal single-access PCNL has a very low complication rate compared to upper calyceal access PCNL, especially pneumothorax and bleeding. |
Databáze: | OpenAIRE |
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