Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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The "Mini-Perc" Technique of Percutaneous Nephrolithotomy with a 14-Fr Peel-away Sheath: 3-year Results in 72 Patients

  • Sung, Yon-Mi (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choo, Sung-Wook (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeon, Seong-Soo (Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Sung-Wook (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Kwang-Bo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Do, Young-Soo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Published : 2006.03.31
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Abstract

Objective: To assess the efficacy and safety of a "mini-perc" technique of percutaneous nephrolithotomy using a 14-Fr peel-away sheath for the removal of pyelocaliceal stones, and to determine appropriate inclusion criteria. Materials and Methods: From July 1999 to June 2002, the medical records and radiographic images of 72 patients who underwent the "mini-perc" technique of percutaneous nephrolithotomy with a 14-Fr peel-away sheath, were reviewed to determine clinical history, stone characteristics, immediate stone free rate, final stone free rate after additional procedures, complications, and hospital stay. We also analyzed the effect of the longest stone diameter, the cumulative longest diameter of stones, the cumulative stone burden, and the stone density on the immediate stone free rate using a Fisher exact test. Results: The only major complication, arterial bleeding, occurred in a patient with Child A liver cirrhosis and was successfully treated by embolization with coils and a gelatin sponge. The immediate stone free rate was 80.6%, which was sig nificantly influenced by stone diameter but not stone density. The mean hospital stay after the procedure was 3.97 days. Conclusion: The "mini-perc" technique of percutaneous nephrolithotomy, which uses the 14-Fr peel-away sheath, is a safe and effective modality for treating renal calculi.

Keywords

References

  1. Puppo P. Percutaneous nephrolithotripsy. Curr Opin Urol 1999;9:325-328 https://doi.org/10.1097/00042307-199907000-00009
  2. Segura JW, Patterson DE, LeRoy AJ, Williams HJ, Barrett DM, Benson RC, et al. Percutaneous removal of kidney stones: review of 1,000 cases. J Urol 1985;134:1077-1081 https://doi.org/10.1016/S0022-5347(17)47633-6
  3. Stoller ML, Wolf JS, Lezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994;152:1977-1981 https://doi.org/10.1016/S0022-5347(17)32283-8
  4. Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F, et al. Complications of percutaneous nephrolithotomy. AJR Am J Roentgenol 1987;148:177-180 https://doi.org/10.2214/ajr.148.1.177
  5. Kessaris DN, Bellman GC, Pardalidis NP, Smith AD. Management of hemorrhage after percutaneous renal surgery. J Urol 1995;153:604-608 https://doi.org/10.1016/S0022-5347(01)67659-6
  6. Lingeman JE, Coury TA, Newman DM, Kahnoski RJ, Mertz JH, Mosbaugh PG, et al. Comparison of results and morbidity of percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy. J Urol 1987;138:485-490 https://doi.org/10.1016/S0022-5347(17)43236-8
  7. Helal M, Black T, Lockhart J, Figueroa TE. The Hickman peelaway sheath: alternative for pediatric percutaneous nephrolithotomy. J Endourol 1997;11:171-172 https://doi.org/10.1089/end.1997.11.171
  8. Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW. The 'mini-perc' technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 1998;16:371-374 https://doi.org/10.1007/s003450050083
  9. Jackman SV, Hedican SP, Peters CA, Docimo SG. Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 1998;52:697-701 https://doi.org/10.1016/S0090-4295(98)00315-X
  10. Monga M. Mini-percutaneous antegrade endopyelotomy. Tech Urol 1999;5:223-225
  11. Monga M, Oglevie S. Minipercutaneous nephrolithotomy. J Endourol 2000;14:419-421 https://doi.org/10.1089/end.2000.14.419
  12. Lahme S, Bichler KH, Strohmaier WL, Gotz T. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 2001;40:619-624 https://doi.org/10.1159/000049847
  13. Fernstrom I, Johansson B. Percutaneous pyelolithotomy: A new extraction technique. Scand J Urol Nephrol 1976;10:257-259 https://doi.org/10.1080/21681805.1976.11882084
  14. Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, et al. Nephrolithiasis clinical guidelines panel summary report on the management of staghorn calculi. The american urological association nephrolithiasis clinical guidelines panel. J Urol 1994;151:1648-1651 https://doi.org/10.1016/S0022-5347(17)35330-2
  15. Rodrigues NN, Claro JA, Ferreira U. Is percutaneous monotherapy for staghorn calculus still indicated in the era of extracorporeal shockwave lithotripsy? J Endourol 1994;8:195-197 https://doi.org/10.1089/end.1994.8.195
  16. Netto NR, Claro JF, Lemos GC, Cortado PL. Renal caluli in lower pole calices: what is the best method of treatment? J Urol 1991;146:721-723 https://doi.org/10.1016/S0022-5347(17)37905-3
  17. Webb DR, Payne SR, Wickham JE. Extracorporeal shockwave lithotripsy and percutaneous renal surgery. Comparisons, combinations and conclusions. Br J Urol 1986;58:1-5 https://doi.org/10.1111/j.1464-410X.1986.tb05416.x
  18. Fuchs G, Miller K, Rassweiler J, Eisenberger F. Extracorporeal shock-wave lithotripsy: one-year experience with the Dornier lithotripter. Eur Urol 1985;11:145-149 https://doi.org/10.1159/000472479
  19. Boddy SA, Kellett MJ, Fletcher MS, Ransley PG, Paris AM, Whitfield HN, et al. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy in children. J Pediatr Surg 1987;22:223-227 https://doi.org/10.1016/S0022-3468(87)80333-0
  20. Sinno K, Boyce WH, Resnick MI. Childhood urolithiasis. J Urol 1979;121:662-664 https://doi.org/10.1016/S0022-5347(17)56932-3