Sri Sivalingam1, Turki Al-Essawi, Denis Hosking. 1. Division of Urology, University of Manitoba Health Sciences Center, Winnipeg, Manitoba, Canada. sri.sivalingam@gmail.com
Abstract
PURPOSE: We retrospectively assessed outcomes in a single institution series of percutaneous nephrolithotomy using retrograde nephrostomy access. MATERIALS AND METHODS: We retrospectively evaluated the records of 333 consecutive patients treated between May 2003 and July 2008. Measured variables included patient demographics, retrograde nephrostomy site, postoperative drainage, operative time, stone clearance rate and degree, requirement for secondary procedures, stone composition and complications. RESULTS: A total of 333 patients were included in study, including 162 females and 171 males with a median age of 56 years (range 17 to 87). Median hospital stay was 2 days (range 1 to 13). Antegrade access was required in 14 patients (4%) due to difficult or suboptimal anatomy. A nephrostomy tube was placed in 33 of 329 patients (10%), mainly for postoperative irrigation. Mean operative time was 76 minutes (range 25 to 246). Of the patients 79% achieved complete clearance, 19% had residual fragments 4 mm or less and 2% had significant persistent stones greater than 4 mm. Postoperatively 11 patients (3%) required shock wave lithotripsy. Analysis revealed calcium oxalate in 57% of stones, uric acid in 24%, struvite in 5% (infection stones) and other in 21%. Complications included 4 patients (1%) with significant postoperative hemorrhage, including angioembolization in 2, transfusion of 4 U packed red blood cells in 1 and observation in 1. CONCLUSIONS: The retrograde technique to establish a percutaneous nephrostomy tract for percutaneous nephrolithotomy is safe and effective with stone clearance and complication rates comparable to those of antegrade access.
PURPOSE: We retrospectively assessed outcomes in a single institution series of percutaneous nephrolithotomy using retrograde nephrostomy access. MATERIALS AND METHODS: We retrospectively evaluated the records of 333 consecutive patients treated between May 2003 and July 2008. Measured variables included patient demographics, retrograde nephrostomy site, postoperative drainage, operative time, stone clearance rate and degree, requirement for secondary procedures, stone composition and complications. RESULTS: A total of 333 patients were included in study, including 162 females and 171 males with a median age of 56 years (range 17 to 87). Median hospital stay was 2 days (range 1 to 13). Antegrade access was required in 14 patients (4%) due to difficult or suboptimal anatomy. A nephrostomy tube was placed in 33 of 329 patients (10%), mainly for postoperative irrigation. Mean operative time was 76 minutes (range 25 to 246). Of the patients 79% achieved complete clearance, 19% had residual fragments 4 mm or less and 2% had significant persistent stones greater than 4 mm. Postoperatively 11 patients (3%) required shock wave lithotripsy. Analysis revealed calcium oxalate in 57% of stones, uric acid in 24%, struvite in 5% (infection stones) and other in 21%. Complications included 4 patients (1%) with significant postoperative hemorrhage, including angioembolization in 2, transfusion of 4 U packed red blood cells in 1 and observation in 1. CONCLUSIONS: The retrograde technique to establish a percutaneous nephrostomy tract for percutaneous nephrolithotomy is safe and effective with stone clearance and complication rates comparable to those of antegrade access.
Authors: Sang Cheol Lee; Chang Hee Kim; Kwang Taek Kim; Tae Beom Kim; Khae Hawn Kim; Han Jung; Sang Jin Yoon; Jin Kyu Oh Journal: Korean J Urol Date: 2013-10-15
Authors: Joo Yong Lee; Seong Uk Jeh; Man Deuk Kim; Dong Hyuk Kang; Jong Kyou Kwon; Won Sik Ham; Young Deuk Choi; Kang Su Cho Journal: BMC Urol Date: 2017-06-27 Impact factor: 2.264