1930 MINIMAL INVASIVE PCNL (MPCNL) - PROVEN EFFICIENCY AND SAFETY AFTER MORE THAN 650 CONSECUTIVE PATIENTS

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111930 MINIMAL INVASIVE PCNL (MPCNL) - PROVEN EFFICIENCY AND SAFETY AFTER MORE THAN 650 CONSECUTIVE PATIENTS Volker Zimmermanns, Peter Liske, and Sven Lahme Volker ZimmermannsVolker Zimmermanns Pforzheim, Germany More articles by this author , Peter LiskePeter Liske Pforzheim, Germany More articles by this author , and Sven LahmeSven Lahme Pforzheim, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2111AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Modern treatment of nephrolithiasis tends towards endourological options instead of extensive use of extracorporal shock wave lithotripsy (ESWL). Background of this trend are enhanced or newly invented techniques like MPCNL, flexible ureterorenoscopy (fURS) and laser devices. The specific values of these developments are still to be discussed and conflicting data exists about many of the issues. This study contributes one of the largest series of MPCNL. METHODS 652 consecutive patients (mean age 54.1 ± 15.7) were treated. Data on the stone size and location, stone-free rate, blood transfusions, operating time and complications were recorded prospectively. A subgroup with a stone size of 5cm2 or larger on the plain x-ray film ( n = 183 ) was analyzed separately to determine the applicability to larger stone loads. RESULTS In 649 patients access was possible. On average retreatment rate was 26.4% (subgroup: 35.5%). The mean stone size was 4.1 cm2 (subgroup: 9.5 cm2) The average operating time was 65 ± 31 min. (subgroup: 77 ± 34 min). Overall stone-free rate was 93.6% (subgroup: 91.8%). Blood transfusions were needed in nine cases (1.4%, subgroup: 1.1%). Febrile pyelonephritis was observed in 49 patients (7.5%, subgroup: 8.7%). One arterio-venous fistula and two recurrent arterial bleedings occurred. Two of the patients needed interventional radiology to resolve the problem. One cerebral ischemia was observed on the first postoperative day. CONCLUSIONS MPCNL proofs to be a reliable and effective technique for percutaneous surgery. Complication rate is similar to that of ESWL and lower than the rates reported in most PCNL studies. Originally intended to be an alternative for ESWL in cases of lower pole calicyal stones or smaller stones in the renal pelvis, MPCNL demonstrates to be effective and equally save in larger stone burden as well. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e772 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Volker Zimmermanns Pforzheim, Germany More articles by this author Peter Liske Pforzheim, Germany More articles by this author Sven Lahme Pforzheim, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...