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Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study.
Urolithiasis. 2017 Aug; 45(4):407-414.U

Abstract

To evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pneumatic lithotripter. All patients were followed-up for 2-3 years. Stone-free rate was defined as absence of residual fragments ≥2 mm. Student-T, Mann-Whitney, Chi square (χ 2), Fisher-exact, one way ANOVA or Kruskal-Wallis test were used for analysis. Mini-PNL was performed for 59 patients (20 horseshoe, 15 malrotated, 7 polycystic, 13 duplex and 4 ectopic pelvic-kidneys). Mean age was 40.18 ± 12.75 (14-78) years. Mean stone burden was 31.72 ± 21.43 (7.85-141.3) mm2. Two tracts were required in 7 (11.9 %) patients. Tubeless Mini-PNL with double-J insertion was performed in all patients except two. Operative time was 50.17 ± 18.73 (15-105) min. Hemoglobin loss was 0.44 ± 0.30 (0-1.4) g/dL. Complications were reported in 15 (25.4 %) patients. No pleural injury, sepsis, perinephric-collection or renal-pelvis perforation were reported. Stone-free rate was 89.8 % (converted to open-surgery in one patient, second-look PNL in two patients, auxiliary SWL in three patients). Stone-free rate improved to 98.3 % after retreatment and auxiliary SWL. Site of puncture was mostly upper calyceal in horseshoe-kidney (80 %), mid calyceal in polycystic-kidney (85.7 %) and lower calyceal in duplex-kidney (46.2 %). Punctures were also significantly infracostal in horseshoe-kidney (100 %) and supracostal in both duplex (53.8 %) and malrotated-kidneys (66.7 %). Mini-PNL is safe for management of stones in anomalous-kidney with SFR comparable to standard-PNL but with less complications.

Authors+Show Affiliations

Endourologists, Vayodah and Venus International Hospitals, Kathmandu, Nepal.Vayodah and Venus International Hospitals, Kathmandu, Nepal. Department of Anaesthesiology, Kathmandu Medical College, Kathmandu, Nepal.Urology Department, Fayoum University, Fayoum, Egypt.Endourologists, Vayodah and Venus International Hospitals, Kathmandu, Nepal.Urology Department, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt. mohammedshemy@yahoo.com.Kuwait University, Kuwait, Kuwait.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27704184

Citation

Khadgi, Sanjay, et al. "Mini-percutaneous Nephrolithotomy for Stones in Anomalous-kidneys: a Prospective Study." Urolithiasis, vol. 45, no. 4, 2017, pp. 407-414.
Khadgi S, Shrestha B, Ibrahim H, et al. Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study. Urolithiasis. 2017;45(4):407-414.
Khadgi, S., Shrestha, B., Ibrahim, H., Shrestha, S., ElSheemy, M. S., & Al-Kandari, A. M. (2017). Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study. Urolithiasis, 45(4), 407-414. https://doi.org/10.1007/s00240-016-0926-1
Khadgi S, et al. Mini-percutaneous Nephrolithotomy for Stones in Anomalous-kidneys: a Prospective Study. Urolithiasis. 2017;45(4):407-414. PubMed PMID: 27704184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study. AU - Khadgi,Sanjay, AU - Shrestha,Babu, AU - Ibrahim,Hamdy, AU - Shrestha,Sunil, AU - ElSheemy,Mohammed S, AU - Al-Kandari,Ahmed M, Y1 - 2016/10/04/ PY - 2016/07/23/received PY - 2016/09/27/accepted PY - 2016/10/6/pubmed PY - 2018/4/20/medline PY - 2016/10/6/entrez KW - Anomalous kidney KW - Horseshoe kidney KW - Mini-percutaneous nephrolithotomy KW - Polycystic kidney KW - Renal stones SP - 407 EP - 414 JF - Urolithiasis JO - Urolithiasis VL - 45 IS - 4 N2 - To evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pneumatic lithotripter. All patients were followed-up for 2-3 years. Stone-free rate was defined as absence of residual fragments ≥2 mm. Student-T, Mann-Whitney, Chi square (χ 2), Fisher-exact, one way ANOVA or Kruskal-Wallis test were used for analysis. Mini-PNL was performed for 59 patients (20 horseshoe, 15 malrotated, 7 polycystic, 13 duplex and 4 ectopic pelvic-kidneys). Mean age was 40.18 ± 12.75 (14-78) years. Mean stone burden was 31.72 ± 21.43 (7.85-141.3) mm2. Two tracts were required in 7 (11.9 %) patients. Tubeless Mini-PNL with double-J insertion was performed in all patients except two. Operative time was 50.17 ± 18.73 (15-105) min. Hemoglobin loss was 0.44 ± 0.30 (0-1.4) g/dL. Complications were reported in 15 (25.4 %) patients. No pleural injury, sepsis, perinephric-collection or renal-pelvis perforation were reported. Stone-free rate was 89.8 % (converted to open-surgery in one patient, second-look PNL in two patients, auxiliary SWL in three patients). Stone-free rate improved to 98.3 % after retreatment and auxiliary SWL. Site of puncture was mostly upper calyceal in horseshoe-kidney (80 %), mid calyceal in polycystic-kidney (85.7 %) and lower calyceal in duplex-kidney (46.2 %). Punctures were also significantly infracostal in horseshoe-kidney (100 %) and supracostal in both duplex (53.8 %) and malrotated-kidneys (66.7 %). Mini-PNL is safe for management of stones in anomalous-kidney with SFR comparable to standard-PNL but with less complications. SN - 2194-7236 UR - https://www.unboundmedicine.com/medline/citation/27704184/Mini_percutaneous_nephrolithotomy_for_stones_in_anomalous_kidneys:_a_prospective_study_ L2 - https://dx.doi.org/10.1007/s00240-016-0926-1 DB - PRIME DP - Unbound Medicine ER -