Ultra-mini-percutaneous nephrolithotomy (PCNL) versus standard PCNL: A randomised clinical trial

Objective: To assess the effectiveness and advantages of ultra-mini-percutaneous nephrolithotomy (UM-PCNL) versus standard PCNL (S-PCNL), as one of the most important differences between the various PCNL techniques is the size of the renal access, which contributes to the broad spectrum of complicat...

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Autores principales: Ramin Haghighi, Hossein Zeraati, Maryam Ghorban Zade
Formato: article
Lenguaje:EN
Publicado: Taylor & Francis Group 2017
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Acceso en línea:https://doaj.org/article/fe4bca3a99c643bbab5e08ef479f4287
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Sumario:Objective: To assess the effectiveness and advantages of ultra-mini-percutaneous nephrolithotomy (UM-PCNL) versus standard PCNL (S-PCNL), as one of the most important differences between the various PCNL techniques is the size of the renal access, which contributes to the broad spectrum of complications and outcomes. Patients and methods: This clinical randomised trial was conducted in 2016. In all, 70 patients with renal or upper ureteric stones of 10â20â¯mm in diameter, who were candidates for PCNL, were divided equally into two groups. Group A, underwent UM-PCNL using a 9.8-F ureteroscope through a 16-F sheath; and Group B, underwent S-PCNL using a 24-F nephroscope through a 30-F sheath. The stones were fragmented by pneumatic lithotripsy. Any perioperative complications and need for analgesia were recorded, and postoperative pain was assessed in both groups using a visual analogue scale (VAS). Results: There were statistically significant differences in postoperative haemoglobin values, haemoglobin drop, transfusion rate, duration of hospitalisation and postoperative VAS pain score between the groups (Pâ¯<â¯0.05). There were no significant differences in operation time, need for auxiliary procedures or stone-free rate. Conclusion: A minimally invasive UM-PCNL using a 9.8-F ureteroscope can play an important role in the treatment of symptomatic renal and upper ureteric stones of <20â¯mm in diameter with lesser blood loss, duration of hospitalisation, need of transfusion, and postoperative pain compared with S-PCNL. Keywords: Ultra-mini-percutaneous nephrolithotomy, Standard percutaneous nephrolithotomy, Renal/upper ureteric stones, Outcomes