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. 2024 Oct 28;11(1):70.
doi: 10.1186/s40779-024-00562-3.

International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Guo-Hua Zeng #  1 , Wen Zhong #  2 , Giorgio Mazzon #  3 , Wei Zhu  2 , Sven Lahme  4 , Sanjay Khadgi  5 , Janak Desai  6 , Madhu Agrawal  7 , David Schulsinger  8 , Mantu Gupta  9 , Emanuele Montanari  10 , Juan Manuel Lopez Martinez  11 , Shabir Almousawi  12 , Vincent Emanuel F Malonzo  13 , Seshadri Sriprasad  14 , Chu Ann Chai  15 , Vimoshan Arumuham  16 , Stefania Ferretti  17 , Wissam Kamal  18 , Ke-Wei Xu  19 , Fan Cheng  20 , Xiao-Feng Gao  21 , Ji-Wen Cheng  22 , Bhaskar Somani  23 , Mordechai Duvdevani  24 , Kah Ann Git  25 , Christian Seitz  26 , Norberto Bernardo  27 , Tarek Ahmed Amin Ibrahim  28 , Albert Aquino  29 , Takahiro Yasui  30 , Cristian Fiori  31 , Thomas Knoll  32 , Athanasios Papatsoris  33 , Nariman Gadzhiev  34 , Ulanbek Zhanbyrbekuly  35 , Oriol Angerri  36 , Hugo Lopez Ramos  37 , Iliya Saltirov  38 , Mohamad Moussa  39 , Guido Giusti  40 , Fabio Vicentini  41 , Edgar Beltran Suarez  42 , Margaret Pearle  43 , Glenn M Preminger  44 , Qing-Hui Wu  45 , Otas Durutovic  46 , Khurshid Ghani  47 , Marcus Maroccolo  48 , Marianne Brehmer  49 , Palle J Osther  50 , Marek Zawadzki  51 , Azimdjon Tursunkulov  52 , Monolov Nurbek Kytaibekovich  53 , Abdusamad Abdukakhorovich Abuvohidov  54 , Cesar Antonio Recalde Lara  55 , Zamari Noori  56 , Stefano Paolo Zanetti  57 , Sunil Shrestha  58 , Jean de la Rosette  59 , John Denstedt  60 , Zhang-Qun Ye  61 , Kemal Sarica  62 , Simon Choong  63
Affiliations

International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Guo-Hua Zeng et al. Mil Med Res. .

Erratum in

  • Correction: International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy.
    Zeng GH, Zhong W, Mazzon G, Zhu W, Lahme S, Khadgi S, Desai J, Agrawal M, Schulsinger D, Gupta M, Montanari E, Martinez JML, Almousawi S, Malonzo VEF, Sriprasad S, Durutovic O, Arumuham V, Ferretti S, Kamal W, Xu KW, Cheng F, Gao XF, Cheng JW, Somani B, Duvdevani M, Git KA, Seitz C, Bernardo N, Ibrahim TAA, Aquino A, Yasui T, Fiori C, Knoll T, Papatsoris A, Gadzhiev N, Zhanbyrbekuly U, Angerri O, Ramos HL, Saltirov I, Moussa M, Giusti G, Vicentini F, Suarez EB, Pearle M, Preminger GM, Wu QH, Chai CA, Ghani K, Maroccolo M, Brehmer M, Osther PJ, Zawadzki M, Tursunkulov A, Kytaibekovich MN, Abuvohidov AA, Lara CAR, Noori Z, Zanetti SP, Shrestha S, de la Rosette J, Denstedt J, Ye ZQ, Sarica K, Choong S. Zeng GH, et al. Mil Med Res. 2024 Dec 16;11(1):79. doi: 10.1186/s40779-024-00579-8. Mil Med Res. 2024. PMID: 39676164 Free PMC article. No abstract available.

Abstract

Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts' experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

Keywords: Expert consensus; Kidney stone; Miniaturized PCNL (mPCNL); Operation; Percutaneous nephrolithotomy (PCNL).

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Conflict of interest statement

The authors declare that they have no competing interests.

Comment in

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