Document Detail


Third prize: contemporary percutaneous nephrolithotripsy: 1585 procedures in 1338 consecutive patients.
MedLine Citation:
PMID:  17867936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The approach to urinary-stone disease has changed dramatically over the last three decades with a transition from open surgery to minimally invasive procedures. Percutaneous nephrolithotripsy (PCNL) is a cornerstone of the treatment of kidney and selected upper-ureteral stones and continues to evolve with advances in techniques and instrumentation. The purpose of this study was to assess outcomes and trends prospectively in a large contemporary group of patients undergoing PCNL. PATIENTS AND METHODS: Between July 1990 and December 2005, all 1338 patients at a single center scheduled for PCNL (N = 1585 procedures) were enrolled. Their mean age was 53 years (range 4-89 years). Data including comorbidities, stone burden, stone location, surgical time, hospital length of stay, rate of secondary procedures, and adverse events were collected prospectively. The primary outcome measures were stone-free rate and complications. RESULTS: There was a substantial incidence of comorbid medical conditions (48.8%) and anatomic renal abnormalities (25.3%), demonstrating the diverse and challenging patient population in this contemporary series. The overall stone-free rate at 3 to 6 months of follow-up was 94.8%. CONCLUSIONS: Percutaneous nephrolithotripsy is a highly effective procedure and may be performed in a diverse group of patients with comorbid conditions and renal abnormalities. Improved intracorporeal lithotripters, balloon dilation of the tract, use of flexible instruments, and liberal use of secondary nephroscopy result in excellent stone-free rates with low morbidity.
Authors:
Mordechai Duvdevani; Hassan Razvi; Mario Sofer; Darren T Beiko; Linda Nott; Ben H Chew; John D Denstedt
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  21     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-09-17     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-9     Citation Subset:  IM    
Affiliation:
Division of Urology, The University of Western Ontario, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Awards and Prizes
Child
Child, Preschool
Comorbidity
Disease-Free Survival
Female
Follow-Up Studies
Humans
Length of Stay / statistics & numerical data
Lithotripsy / adverse effects,  statistics & numerical data*
Male
Middle Aged
Nephrostomy, Percutaneous / adverse effects,  statistics & numerical data*
Postoperative Complications / epidemiology
Prospective Studies
Treatment Outcome
Urinary Calculi / epidemiology*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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