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. 2022 Mar;40(3):789-794.
doi: 10.1007/s00345-021-03894-0. Epub 2021 Dec 2.

The use of ureteral access sheath during mini-percutaneous nephrolithotomy with high-power holmium YAG laser

Arman Tsaturyan  1 , Marco Lattarulo  1 , Constantinos Adamou  1 , Konstantinos Pagonis  1 , Angelis Peteinaris  1 , Despoina Liourdi  1   2 , Theofanis Vrettos  3 , Evangelos Liatsikos  4   5   6 , Panagiotis Kallidonis  1
Affiliations

The use of ureteral access sheath during mini-percutaneous nephrolithotomy with high-power holmium YAG laser

Arman Tsaturyan et al. World J Urol. 2022 Mar.

Abstract

Purpose: To present our preliminary results and describe a technical modification of mini-PCNL (12Fr) with the insertion of a ureteral access sheath (UAS) to facilitate the procedure.

Methods: A prospective study for the time period of January 2020 to January 2021 was conducted including patients with renal stones sized ≤ 25 mm in whom prone mini-PCNL (tract size 12Fr) together with the retrograde insertion of UAS was performed. All patients had been prestented at least 1 week prior to the planned surgery. A single-step tract dilation to 12Fr diameter was performed through a nonpapillary medial puncture. The lithotripsy was achieved using high-power holmium yttrium aluminum garnet laser (Ho:YAG) with the 60 W power setting (40 Hz and 1.5 J). The follow-up investigations were planned at 1-month after the surgery.

Results: In total, 32 patients with the median age and stone size of 56.5 (IQR = 53-62) years and 20.8 (IQR = 19.3-22.7) mm were included. The median operative and cumulative fluoroscopy time were 34.0 (IQR = 29.9-37.5) and 1.9 (1.8-2.1) min, respectively. The stone-free rate (SFR) at 1-month follow-up was 93.8% (30/32). Only one patient developed a fever and required prolonged antibiotic administration. None of the patients experienced clinically significant bleeding.

Conclusion: Our preliminary results showed that the use of UASs during mini-PCNL procedures is feasible and provides directed evacuation of the stone fragments reaching 93.8% SFR at a 1-month follow-up. Future well-designed studies are necessary to prove our findings.

Keywords: High power Ho:YAG; Intrarenal pressure; Mini-PCNL; Ureteral access sheath.

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References

    1. Kallidonis P, Panagopoulos V, Kyriazis I, Liatsikos E (2016) Complications of percutaneous nephrolithotomy: classification, management, and prevention. Curr Opin Urol 26(1):88–94. https://doi.org/10.1097/MOU.0000000000000232 - DOI - PubMed
    1. Schilling D, Husch T, Bader M, Herrmann TR, Nagele U, Training, Research in Urological S, Technology (2015) Nomenclature in PCNL or The tower of babel: a proposal for a uniform terminology. World J Urol 33(11):1905–1907. https://doi.org/10.1007/s00345-015-1506-7 - DOI - PubMed
    1. Guler A, Erbin A, Ucpinar B, Savun M, Sarilar O, Akbulut MF (2019) Comparison of miniaturized percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for the treatment of large kidney stones: a randomized prospective study. Urolithiasis 47(3):289–295. https://doi.org/10.1007/s00240-018-1061-y - DOI - PubMed
    1. Kandemir E, Savun M, Sezer A, Erbin A, Akbulut MF, Sarilar O (2020) Comparison of miniaturized percutaneous nephrolithotomy and standard percutaneous nephrolithotomy in secondary patients: a randomized prospective study. J Endourol 34(1):26–32. https://doi.org/10.1089/end.2019.0538 - DOI - PubMed
    1. Tokas T, Skolarikos A, Herrmann TRW, Nagele U, Training, Research in Urological S, Technology G (2019) Pressure matters 2: intrarenal pressure ranges during upper-tract endourological procedures. World J Urol 37(1):133–142. https://doi.org/10.1007/s00345-018-2379-3 - DOI - PubMed

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