Development and validation of a simple stone score to estimate the probability of residual stones prior to percutaneous nephrolithotomy

2021 ◽  
Vol 73 (4) ◽  
Author(s):  
Ahmed M. HARRAZ ◽  
Ahmed R. EL-NAHAS ◽  
Mohamed A. NABEEH ◽  
Mahmoud LAYMON ◽  
Khalid Z. SHEIR ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Development And Validation ◽  
Residual Stones

scholarly journals Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study

Urolithiasis ◽  
2021 ◽  
Author(s):  
R. A. Kingma ◽  
M. J. H. Voskamp ◽  
B. H. J. Doornweerd ◽  
I. J. de Jong ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
University Hospital ◽  
Cone Beam ◽  
Cross Sectional ◽  
The Mean ◽  
Residual Stones ◽  
Residual Fragments

AbstractCone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible.

scholarly journals Safety and efficacy of the supracostal access for percutaneous nephrolithotomy: Our initial experience

1970 ◽  
Vol 37 (1) ◽  
pp. 34-38 ◽  
Author(s):  
M Hossain ◽  
ATMA Ullah ◽  
S Regmi ◽  
H Rahman ◽  
SAMG Kibria
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Complication Rate ◽  
Postoperative Hospital Stay ◽  
Initial Experience ◽  
Safety And Efficacy ◽  
Stone Clearance ◽  
Secondary Procedures ◽  
Residual Stones ◽  
Staghorn Stones ◽  
Made In

The aim of this study was to evaluate the safety and efficacy of the supracostal access for percutaneous nephrolithotomy (PCNL). Between July 2007 and June 2010, 122 patients underwent PCNL, of whom 28 (23%) had supracostal access. All procedures were performed in a single sitting under general anesthesia. The data were analysed for indications, stone clearance rates and the complications associated with supracostal puncture. The indications for a supracostal access were staghorn stones (50%), pelvis stones (28.5%), calyceal stones in high-lying kidney (18%) and upper ureter/ureteric stones (3.5%). All tracts were made in the 11th intercostal space. Single tract access was used in 22 cases (78%), but 6 (22%) required a second tract. Additional punctures were required mainly for staghorn stones (4 out of 14). Overall, 82% of the patients were rendered stone free or had clinically insignificant residual stones with PCNL monotherapy, and this increased to 96% with secondary procedures. In patients with staghorn stones, they were completely cleared in 78%. Overall complication rate was 28% and included hydrothorax in 3 (10%) patients, which required insertion of a chest tube. One (3.5%) patient developed haemothorax secondary to injury of the intercostal artery, pelvic perforation in 1 (3.5%), perinephric collection in 1 (3.5%), infection/sepsis in 2 (7%). Except those patients who had complication, all other patient recovered uneventfully. Postoperative hospital stay ranged from 2 to 9 days. In conclusion, supracostal access gives high clearance rate with acceptable complications and should not be avoided for fear of chest complications. DOI:  http://dx.doi.org/10.3329/bmrcb.v37i1.7797 Bangladesh Med Res Counc Bull 2011; 37: 34 - 38  

Residual stones after percutaneous nephrolithotomy: comparison of intraoperative assessment and postoperative non-contrast computerized tomography

2016 ◽  
Vol 35 (8) ◽  
pp. 1241-1246 ◽  
Author(s):  
Ahmed M. Harraz ◽  
Yasser Osman ◽  
Ahmed R. EL-Nahas ◽  
Amr A. Elsawy ◽  
Islam Fakhreldin ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Intraoperative Assessment ◽  
Residual Stones
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