PURPOSE: To evaluate the usefulness of routine flexible nephroscopy during percutaneous nephrolithotomy (PCNL) surgery.
MATERIALS AND METHODS: Patients diagnosed with kidney stones and scheduled to undergo PCNL between March 2011 and July 2012 were randomized into 2 groups: group 1 underwent standard PCNL using rigid nephroscopy; group 2 underwent flexible nephroscopy in addition to standard PCNL, and laser lithotripsy or basket catheter stone extraction when necessary. Surgery was performed subcostally and with minimal percutaneous access in group 2, so as to make use of the advantages of flexible nephroscopy. The two groups were compared in terms of preoperative stone characteristics and postoperative success criteria, including the stone -free rate, bleeding, and number of access, etc.
RESULTS: The study included 80 patients, of which 61 (76.3%) were male and 19 (23.8%) were female. Mean age of the patients was 43.75 ± 12.4 years (range: 19-74 years). There were no significant differences in stone size, Hounsfield unit (HU) density, or stone location between the two groups. Comparison of perioperative and postoperative parameters showed that group 2 had a higher stone-free rate (92.5% vs. 70%), a lower number of access, and lower decrease in the hematocrit. The stone-free rate was higher in the patients that had stones with an HU density < 677.5 (100% in group 2 vs. 64.7% in group 1).
CONCLUSIONS: Routine use of flexible nephroscopy during PCNL was associated with a higher stone-free rate, and fewer interventions and bleeding, especially in patients with low HU density stones.
Written by:
Gücük A, Kemahlı E, Uyetürk U, Tuygun C, Yıldız M, Metin A. Are you the author?
Department of Urology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
Reference: J Urol. 2013 Jan 9. pii: S0022-5347(13)00025-6.
doi: 10.1016/j.juro.2013.01.009
PubMed Abstract
PMID: 23313202
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