Effect of different tracts of percutaneous nephrolithotomy on the efficacy of complete staghorn calculus_West China Medical Journal

Authors：

ZHANG Yu , BAI Yunjin , TANG Yin , WANG Jia ,  WEI Wuran

Department of Urology / Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WEI Wuran, Email: jitamao55@163.com

Keywords：

Complete staghorn calculus; Percutaneous nephrolithotomy; Tract

DOI：

10.7507/1002-0179.202001005

Video：

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Objective To explore the impact of different tracts on the effectiveness and safety of percutaneous nephrolithotomy (PCNL) on complete staghorn calculus.Methods Patients with complete staghorn calculus who underwent single channel PCNL by the same surgeon in West China Hospital of Sichuan University from October 2009 to August 2019 were included. The removing time, the rate of immediate stone removal, the average extubating time, and the incidences of postoperate complications such as fever and bleeding were analyzed statistically.Results A total of 379 patients were included. There were 146 cases in the upper tract group, 170 cases in the lower tract group and 63 cases in the middle tract group. Compared with the upper and middle tract groups, the lower tract group had shorter stone removing time [(50.34±18.52) vs. (53.41±22.75) vs. (41.79±17.45) min, P<0.001], shorter average extubating time [(5.53±1.83) vs. (6.17±1.44) vs. (4.96±1.91) d, P=0.007]. The rate of immediate stone removal was higher in the the upper tract group (40.56% vs. 32.79% vs. 34.71% ), but there was no statistical difference among the three groups (P=0.447). There was no significant difference among the three groups in the fever incidence (25.44% vs. 24.24% vs. 26.85%, P=0.938) or bleeding incidence (3.54% vs. 3.03% vs. 4.03%, P=1.000). In addition, there were 8 cases of pleural injury in the upper tract group.Conclusions Compared with the lower and middle tract, PCNL with upper tract has a higher rate of removing stones for complete staghorn calculus, but there was no significant difference among the three groups. The incidences of bleeding and fever after surgery are similar in the three groups, but the risk of pleural injury may be increased in the upper tract group.

Citation： ZHANG Yu, BAI Yunjin, TANG Yin, WANG Jia, WEI Wuran. Effect of different tracts of percutaneous nephrolithotomy on the efficacy of complete staghorn calculus. West China Medical Journal, 2021, 36(8): 1068-1071. doi: 10.7507/1002-0179.202001005 Copy

1.	张贺庆, 郑彬, 陈岳, 等. 经中盏与经上盏经皮肾镜取石术治疗鹿角形肾结石的效果比较. 广东医学, 2016, 37(增刊): 155-157.
2.	Singh R, Kankalia SP, Sabale V, et al. Comparative evaluation of upper versus lower calyceal approach in percutaneous rephrolithotomy for managing complex renal calculi. Urol Ann, 2015, 7(1): 31-35.
3.	Sinha M, Krishnappa P, Subudhi SK, et al. Supracostal percutaneous nephrolithotomy: a prospective comparative study. Indian J Urol, 2016, 32(1): 45-49.
4.	Pérez-Fentes D. Techniques for percutaneous access during percutaneous nephrolithotomy. Arch Esp Urol, 2017, 70(1): 155-172.
5.	那彦群, 叶章群, 孙颖浩, 等. 中国泌尿外科疾病诊断治疗指南(2014 年版). 北京: 人民卫生出版社, 2014.
6.	Malkhasyan VA, Semenyakin IV, Ivanov VY, et al. Complications of percutaneous nephrolithotomy and their management. Urologiia, 2018(4): 147-153.
7.	Morganstern B, Galli R, Motamedinia P, et al. Percutaneous nephrolithotomy in octogenarians and beyond: how old is too old?. Asian J Urol, 2015, 2(4): 208-213.
8.	Sampaio FJ, Aragão AH. Anatomical relationship between the renal venous arrangement and the kidney collecting system. J Urol, 1990, 144(5): 1089.
9.	Sharma K, Sankhwar SN, Singh V, et al. Evaluation of factors predicting clinical pleural injury during percutaneous nephrolithotomy: a prospective study. Urolithiasis, 2016, 44(3): 263-270.
10.	Rassweiler JJ, Renner C, Eisenberger F. The management of complex renal stones. BJU Int, 2000, 86(8): 919-928.
11.	Soares RMO, Zhu A, Talati VM, et al. Upper pole access for prone percutaneous nephrolithotomy: advantage or risk?. Urology, 2019(134): 66-71.
12.	Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy: an update. Curr Opin Urol, 2003, 13(3): 235-241.
13.	Knoll T, Daels F, Desai J, et al. Percutaneous nephrolithotomy: technique. World J Urol, 2017, 2017, 35(9): 1361-1368.
14.	Rashid AO, Fakhulddin SS. Risk factors for fever and sepsis after percutaneous nephrolithotomy. Asian J Urol, 2016, 3(2): 82-87.
15.	Lai WS, Assimos D. The role of antibiotic prophylaxis in percutaneous nephrolithotomy. Rev Urol, 2016, 18(1): 10-14.
16.	Doğan HS, Sahin A, Cetinkaya Y, et al. Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients. J Endourol, 2002, 16(9): 649-653.
17.	Vorrakitpokatorn P, Permtongchuchai K, Raksamani EO, et al. Perioperative complications and risk factors of percutaneous nephrolithotomy. J Med Assoc Thai, 2006, 89(6): 826-833.

1. 张贺庆, 郑彬, 陈岳, 等. 经中盏与经上盏经皮肾镜取石术治疗鹿角形肾结石的效果比较. 广东医学, 2016, 37(增刊): 155-157.
2. Singh R, Kankalia SP, Sabale V, et al. Comparative evaluation of upper versus lower calyceal approach in percutaneous rephrolithotomy for managing complex renal calculi. Urol Ann, 2015, 7(1): 31-35.
3. Sinha M, Krishnappa P, Subudhi SK, et al. Supracostal percutaneous nephrolithotomy: a prospective comparative study. Indian J Urol, 2016, 32(1): 45-49.
4. Pérez-Fentes D. Techniques for percutaneous access during percutaneous nephrolithotomy. Arch Esp Urol, 2017, 70(1): 155-172.
5. 那彦群, 叶章群, 孙颖浩, 等. 中国泌尿外科疾病诊断治疗指南(2014 年版). 北京: 人民卫生出版社, 2014.
6. Malkhasyan VA, Semenyakin IV, Ivanov VY, et al. Complications of percutaneous nephrolithotomy and their management. Urologiia, 2018(4): 147-153.
7. Morganstern B, Galli R, Motamedinia P, et al. Percutaneous nephrolithotomy in octogenarians and beyond: how old is too old?. Asian J Urol, 2015, 2(4): 208-213.
8. Sampaio FJ, Aragão AH. Anatomical relationship between the renal venous arrangement and the kidney collecting system. J Urol, 1990, 144(5): 1089.
9. Sharma K, Sankhwar SN, Singh V, et al. Evaluation of factors predicting clinical pleural injury during percutaneous nephrolithotomy: a prospective study. Urolithiasis, 2016, 44(3): 263-270.
10. Rassweiler JJ, Renner C, Eisenberger F. The management of complex renal stones. BJU Int, 2000, 86(8): 919-928.
11. Soares RMO, Zhu A, Talati VM, et al. Upper pole access for prone percutaneous nephrolithotomy: advantage or risk?. Urology, 2019(134): 66-71.
12. Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy: an update. Curr Opin Urol, 2003, 13(3): 235-241.
13. Knoll T, Daels F, Desai J, et al. Percutaneous nephrolithotomy: technique. World J Urol, 2017, 2017, 35(9): 1361-1368.
14. Rashid AO, Fakhulddin SS. Risk factors for fever and sepsis after percutaneous nephrolithotomy. Asian J Urol, 2016, 3(2): 82-87.
15. Lai WS, Assimos D. The role of antibiotic prophylaxis in percutaneous nephrolithotomy. Rev Urol, 2016, 18(1): 10-14.
16. Doğan HS, Sahin A, Cetinkaya Y, et al. Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients. J Endourol, 2002, 16(9): 649-653.
17. Vorrakitpokatorn P, Permtongchuchai K, Raksamani EO, et al. Perioperative complications and risk factors of percutaneous nephrolithotomy. J Med Assoc Thai, 2006, 89(6): 826-833.

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Effect of different tracts of percutaneous nephrolithotomy on the efficacy of complete staghorn calculus

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