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. 2013:2013:490793.
doi: 10.1155/2013/490793. Epub 2013 Jul 24.

A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm

Janak Desai  1 , Guohua Zeng, Zhijian Zhao, Wen Zhong, Wenzhong Chen, Wenqi Wu
Affiliations

A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm

Janak Desai et al. Biomed Res Int. 2013.

Abstract

Objectives: To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11-13 Fr metal sheath to perform holmium: YAG laser lithotripsy.

Methods: The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status.

Results: The mean stone size was 14.9 ± 4.1 mm (rang: 6-20). The average operative time was 59.8 ± 15.9 (30-90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2-5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion.

Conclusions: UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

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Figures

Figure 1
Figure 1
Special basic instruments set of the UMP. (a) Working metal sheath and its obturator. (b) Spatial location of the fine tube, obturator, guide wire and laser fiber, and water jet out from inner fine tube. (c) Mininephroscope assembled with a 3.5 Fr telescope and a 6 Fr demountable telescope (inner) sheath. The 3.5 Fr telescope passes through the central channel. Irrigation connection and laser fiber are each attached to one side port. Optics is connected to a zoom ocular and light adapter. (d) Water jet flush out some larger stone debris (<3 mm) and blood clots through the working sheath after rapid removal of the endoscope.
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References

    1. Albala DM, Assimos DG, Clayman RV, et al. A prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. Journal of Urology. 2001;166(6):2076–2080. - PubMed
    1. Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database of Systematic Reviews. 2009;(4)CD007044 - PubMed
    1. Pearle MS, Lingeman JE, Leveillee R, et al. Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. Journal of Urology. 2005;173(6):2005–2009. - PubMed
    1. Preminger GM. Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urological Research. 2006;34(2):108–111. - PubMed
    1. Resorlu B, Oguz U, Resorlu EB, Oztuna D, Unsal A. The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones. Urology. 2012;79(1):61–66. - PubMed

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