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Non papillary mini-percutaneous nephrolithotomy: early experience.

P Kallidonis1, A Vagionis2, T Vrettos3

  • 1Department of Urology, University Hospital of Patras, Patras, Greece. pkallidonis@yahoo.com.

World Journal of Urology
|May 31, 2020
PubMed
Summary

Non-papillary access for mini-percutaneous nephrolithotomy (mini-PCNL) is safe and effective for kidney stone removal. This technique shows comparable stone-free rates and low complication rates, making it a viable option.

Keywords:
LithotripsyMini-PCNLNon-papillary accessPCNLStone diseaseUrolithiasis

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithotomy

Background:

  • Percutaneous nephrolithotomy (PCNL) is a standard procedure for kidney stone management.
  • Mini-PCNL offers a less invasive approach compared to standard PCNL.
  • Optimizing access techniques for mini-PCNL is crucial for improving safety and efficacy.

Purpose of the Study:

  • To evaluate the safety and efficacy of non-papillary puncture for mini-percutaneous nephrolithotomy (mini-PCNL).
  • To assess perioperative outcomes, including operative time, stone-free rates, and complications.

Main Methods:

  • A prospective study involving 32 patients undergoing mini-PCNL with non-papillary access.
  • Utilized one-step track dilation to 22 Fr, an 18 Fr nephroscope, and an ultrasound lithotripter.
  • Collected demographic and perioperative data retrospectively from an approved database.

Main Results:

  • Average stone size was 23.53 mm; mean operative time was 44.6 minutes.
  • Primary stone-free rates were 96% (single access) and 85.7% (multiple access).
  • Overall complication rate was 9.37% with no severe bleeding; mean hospital stay was 2.56 days.

Conclusions:

  • Non-papillary access for mini-PCNL is associated with minimal blood loss and no transfusions.
  • The safety and efficacy of this approach are comparable to existing literature.
  • Non-papillary access is a safe and advocated method for mini-PCNL.