PD18-05 COMPARATIVE OUTCOMES OF CONVENTIONAL PCNL AND MINIATURIZED PCNL IN THE TREATMENT OF KIDNEY STONES

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2016PD18-05 COMPARATIVE OUTCOMES OF CONVENTIONAL PCNL AND MINIATURIZED PCNL IN THE TREATMENT OF KIDNEY STONES Jessica Lange and Jorge Gutierrez-Aceves Jessica LangeJessica Lange More articles by this author and Jorge Gutierrez-AcevesJorge Gutierrez-Aceves More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1184AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous nephrostolithotomy (PCNL) is the preferred method to treat large renal stones. PCNL has excellent stone free rates, but it known to have increased blood loss, postoperative pain, and hospital stay relative to other treatment modalities. In recent years, techniques used to create a smaller percutaneous tract have gained interest. Miniaturized PCNL (mini-PCNL) requires dilation of a smaller percutaneous tract, potentially leading to less blood loss, less postoperative pain, and shortened hospital stay. In this study, we compare efficacy and outcomes of conventional and mini-PCNL at our institution. METHODS The outcomes of 29 consecutive mini-PCNLs were compared to 27 conventional PCNLs performed by a single surgeon at our institution. Study inclusion criteria included age ≥ 18 years, BMI 18-40 kg/m2, and first look PCNL for stones 1-3.5 cm in greatest dimension. Conventional PCNL required percutaneous tract dilation to 30 French and stone fragmentation using pneumatic and/or ultrasonic lithotrites and/or holmium:YAG laser. Mini-PCNL was performed using the minimally invasive percutaneous access set (Storz®), dilating the tract to 16 French, and using holmium:YAG laser for stone fragmentation. RESULTS There were no significant differences between the groups in baseline age (PCNL 55.5 ± 15.3 years, mini-PCNL 53.0 ± 15.8 years) or BMI (PCNL 28.5 ± 5.7, mini-PCNL 29.0 ± 6.0 kg/m2). There was no significant difference in preoperative stone burden between groups though the mini-PCNL mean stone burden was slightly smaller. Seventeen patients in the conventional PCNL group and 19 patients in the mini-PCNL group were stone free (defined as residual stone fragments < 2 mm on postoperative CT scan) after one procedure. There was no significant difference in residual stone burden, total operative time, or postoperative analgesic use between groups. There was a significant difference in blood loss, but no patients required blood transfusion. CONCLUSIONS Both conventional PCNL and mini-PCNL are effective methods of removing renal stones 1-3.5 cm. There appears to be no difference in residual stone volume, postoperative analgesic use, or operative time between the two techniques. Blood loss was less in the mini-PCNL group though this may have little clinical significance. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e405 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jessica Lange More articles by this author Jorge Gutierrez-Aceves More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...