Document Detail


Ultrasound-guided minimally invasive percutaneous nephrolithotomy in flank position for management of complex renal calculi.
MedLine Citation:
PMID:  20573383     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the safety and efficacy of performing ultrasound-guided minimally invasive percutaneous nephrolithotomy (MPCNL) in the flank position for the management of complex renal calculi. Percutaneous nephrolithotomy is usually performed with the patient in the prone position under fluoroscopic guidance; however, this position, and guidance method have some limitations.
METHODS: From January 2007 to December 2009, 93 patients (101 kidneys) with complex renal calculi underwent ultrasound-guided MPCNL in the flank position.
RESULTS: The mean age of the patients was 45.3 years (range 29-71). The calculi-free rate in the patients who underwent a single procedure was 78.2% (79 of 101 kidneys). The average operative duration was 82.6 minutes (range 45-190). Although the perioperative blood loss was not significantly different between single-tract and double-tract MPCNL (P = .087, F = 2.981), the calculi-free rate was significantly greater in the patients who underwent double-tract MPCNL than in those who underwent single-tract MPCNL (P = .027, chi-square = 4.873). Perioperative blood transfusions were not required in any patient. Similarly, ureteral calculi due to percutaneous nephrolithotomy were not observed. Secondary renal hemorrhage occurred in 3 patients who had undergone single-tract MPCNL and 1 underwent nephrectomy.
CONCLUSIONS: The results of our study have shown that ultrasound-guided MPCNL with the patient in the flank position is safe and effective for treating complex renal calculi, without the side effects of radiation to the patient and surgeon. Double-tract MPCNL is suitable for complex renal calculi and, in some cases, is required to increase the calculi-free rate. The insertion of twin ureteral catheters before lithotripsy might be helpful in avoiding residual ureteral calculi after percutaneous nephrolithotomy.
Authors:
Yi-Ming Fu; Qi-Yin Chen; Zhong-Shan Zhao; Ming-Hua Ren; Li Ma; Yong-Shun Duan; Zhi-Xing Jiao; Wei Huang; Shao-Bin Ni
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Publication Detail:
Type:  Journal Article     Date:  2010-06-22
Journal Detail:
Title:  Urology     Volume:  77     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Second Department of Urinary Surgery, First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Kidney Calculi / surgery*,  ultrasonography*
Male
Middle Aged
Nephrostomy, Percutaneous / methods*
Patient Positioning*
Retrospective Studies
Surgical Procedures, Minimally Invasive
Ultrasonography, Interventional*

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


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