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Renal calculi
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Eleni Papageorgiou, Naima Smeulders
As a result of the dramatic advances in technology over the last decades, the less invasive techniques of extracorporeal shock-wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS)/retrograde intrarenal surgery (RIRS) and percutaneous cystolithotomy (PCCL) have superseded open surgery for renal calculi in children. Laparoscopic operation may also be considered in some cases.
Empyema from Misplacement of Percutaneous Nephrostomy Tube—A Diagnostic Challenge
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Raed Abdulkareem, Francis J. Podbielski
Urinothorax and nephropleural fistula have been reported soon after placement or removal of percutaneous nephrostomy tubes [1,2]; this complication usually resolved after simple thoracentesis or serial thoracenteses [3]. A similar case from our review is presented by Kumar et al., who described a patient who underwent percutaneous nephrolithotomy (PCNL) for the removal of kidney stones [4]. Thus, to our knowledge, the case presented here in our report is the first of its kind to be reported.
Urology
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Percutaneous nephrolithotomy is a procedure whereby stones in the renal tract are removed with a rigid or flexible endoscope via ultrasound-guided puncture and fluoroscopy-controlled placement of the endoscope. A guidewire is inserted through a hollow needle and advanced into the collecting system. Then tract dilation is performed over the guidewire. At the completion of access tract dilation, a working sheath is left in place to accommodate the endoscope and drain the irrigation fluid. The procedure is particularly indicated in patients with staghorn calculi, and lower pole calculi larger than 10 mm. Patients with stones resistant to extracorporeal shock wave lithotripsy should also be treated by this process. Small calculi are removed through the endoscope under direct vision using a forceps or a stone basket. Stones larger than 1 cm require fragmentation by a lithotripsy device. The most efficient are the ultrasonic and the pneumatic rigid lithotripters. Morbidly obese patients in whom shock wave lithotripsy is impractical or technically impossible may also need to be treated in this way.
The effect of anesthesia type on the outcomes of percutaneous nephrolithotomy in elderly males
Published in Annals of Medicine, 2023
Sedat Oner, Efe Onen, Volkan Caglayan, Sinan Avci, Abdullah Erdogan, Metin Kilic, Serra Topal
The type of anaesthesia that should be employed in percutaneous nephrolithotomy (PNL) has recently intrigued researchers interested in endourology. In the last decade, many studies have been conducted and published on the best type of anaesthesia in PNL, generally covering all age groups [1,2]. However, it is worth noting that these studies have not focused on the elderly population. The anatomy of the kidney, location of kidney stones, size and number of stones, comorbid diseases, and experience of the surgeon are known to affect the success rate of PNL [3]. As the rates of chronic diseases, such as diabetes mellitus, hypertension, coronary artery disease, chronic kidney disease, and the use of anticoagulants due to these diseases are higher in elderly patients, an increased risk of anaesthesia for PNL in the elderly seems to be inevitable. However, the type of anaesthesia chosen in PNL is more important in the elderly than in the younger population, especially considering the complications. It has been shown that anaesthesia results can differ, even with gender, due to pharmacokinetic reasons [4]. Previously, it was shown that women are more resistant to general anaesthesia (GA) and wake up earlier than men, and as a result, the time spent in an operating room was significantly shorter for women than for men [5,6]. Thus, studies evaluating the effects of a combination of parameters, such as age, gender and anaesthesia type, on PNL outcomes are needed. In this study, we aimed to compare the outcomes of PNL due to anaesthesia methods in terms of safety and effectiveness in elderly men.
Concomitant Treatment of Ureteropelvic Junction Obstruction Complicated by Renal Calculi with Laparoscopic Pyeloplasty and Pyelolithotomy via 19.5F Rigid Nephroscope: A Report of 12 Cases
Published in Journal of Investigative Surgery, 2022
Lizhe An, Liulin Xiong, Liang Chen, Xiongjun Ye, Xiaobo Huang
Minimally invasive surgery has been the primary method to treat UPJO. However, how to ideally manage UPJO associated with concomitant ipsilateral calculus is still a challenge. In a quite long period, open pyelolithotomy and pyeloplasty has been the golden standard.5 But as the merging of minimally invasive surgery era, several minimally invasive treatment options have been reported, including percutaneous nephrolithotomy (PNL) with endopyelotomy,6 laparoscopic or robotic-assisted pyeloplasty with the use of flexible and rigid scopes to remove intrarenal stones.7,8 But using flexible cystoscope and ureteroscope is time consuming and it’s difficult to control the flexible endoscope during laparoscopic surgery, also rigid ureteroscopy is less efficient. While we found 19.5 F rigid nephroscope was more efficient. Thus, we aim to introduce our experience of laparoscopic pyeloplasy (LP) and concomitant pyelolithotomy via 19.5 F rigid nephroscope in UPJO complicated by renal calculi and evaluate its feasibility and safety.
Three-dimensionally printed non-biological simulator for percutaneous nephrolithotomy training
Published in Scandinavian Journal of Urology, 2020
Stanislav Ali, Evgenii Sirota, Hussein Ali, Evgenii Bezrukov, Zhamshid Okhunov, Mikhail Bukatov, Alexandr Letunovskiy, Nikolai Grygoriev, Mark Taratkin, Stanislav Vovdenko, Andyshea Afyouni, Yuri Alyaev
Epidemiological studies have shown the 1.7–14.8% prevalence of urolithiasis in the United States, though this statistic continues to increase each year [1]. Today, stone treatment, depending on the severity of the disease, typically comprises minimally invasive endoscopic surgical intervention. In the last two decades, percutaneous nephrolithotomy (PCNL) has become the standard of care to treat exceedingly large kidney stones. Like the overall rate of urolithiasis, the incidence of complex forms of urolithiasis, such as staghorn stones, high-density stones (>1000 HU), and stones in kidneys with abnormal anatomies, comprise roughly 45–60% of all urolithiasis cases [2]. Because of the increased incidence of complex forms of urolithiasis, the use of PCNL has become widespread given its improved stone-free rates over other modalities [3].