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At least 19 recordsLinked to original sources
PubMed1991

A comparison of anatrophic nephrolithotomy and percutaneous nephrolithotomy with and without extracorporeal shock wave lithotripsy for management of patients with staghorn calculi.

A retrospective study was conducted comparing anatrophic nephrolithotomy (10 cases), percutaneous nephrolithotomy alone (4 cases) or percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy (23 cases) for the treatment of large staghorn calculi. A comparison based on collecting system anatomy demonstrated that anatrophic nephrolithotomy resulted in a greater stone-free rate, shorter hospitalization and lower costs while complication rates were similar. Anatrophic nephrolithotomy should still be considered a viable treatment option, especially for patients with large branched calculi in complex collecting systems.

Adult↗
PubMed1992

Percutaneous nephrolithotomy in children.

Percutaneous nephrolithotomy was performed on 18 children with renal calculi. No mortality resulted from this procedure and hemorrhage was the major complication. At the end of treatment 67% of the patients were stone-free and 82% of targeted stones were removed. Percutaneous nephrolithotomy can be considered a successful treatment in the management of the pediatric patient with renal calculi.

Adolescent↗
PubMed1992

Complications attributable to the formation of the track in patients undergoing percutaneous nephrolithotomy.

Reported complication rates of percutaneous nephrolithotomy vary considerably. In our own experience of 110 percutaneous nephrolithotomies performed by an experienced interventional radiologist, the complication rate for the entire procedure was 3.6%, and for the formation of the nephrostomy track 0.9%. This compares favourably with the reports from the major centres. Radiation dose to the operator was monitored and our results confirm that with meticulous attention to technique, dosages may be kept very low. We conclude that prior training in interventional techniques is a major factor in reducing both the morbidity associated with percutaneous nephrolithotomy and the radiation dose to the operator.

Adolescent↗
PubMed1989

[Antibiotic prophylaxis with cefotiam in percutaneous nephrolithotomy].

The percutaneous extraction of renal calculi in patients whose urines are sterile is considered to be a "clean-contaminated" surgery. The post-operatory infection is thought to be the result of the urethral catheter and the nephrostomy tube. The bacteria that are more after implicated are the Gram-negative bacteria. Therefore we found useful to give as a prophylactic treatment cefotiam, which is a 3rd generation cephalosporin, and have the advantage or reaching elevated urinary concentration as well as having a broad-spectrum activity on both Gram-negative bacteria and Staphylococcus. It has been used as follow: 1) with the anesthetic induction give 2 g IV push; 2) these give 1 g IV 12 hourly four times. It has been noted, that in all patients receiving this regimen, no post-operatory infection or urinary tract infection was found during the 48 hours following surgery. Therefore we think that due to the reasonable cost of the regimen, we advise it for this type of surgery.

Adult↗
PubMed1989

Early experience with percutaneous nephrolithotomy.

Fifty-four percutaneous nephrolithotomy (PNL) procedures were performed in 41 patients between May 1986 and December 1987. Six patients required more than one procedure and there was one failure which was treated by open ureterolithotomy. Most of the stones were initially found in the pelvicalyceal system, one in the lower third and nine in the middle or upper third of the ureter. There were five significant complications: one "steinstrasse" (accumulation of stone fragments in the distal ureter after the procedure), one massive perirenal haematoma, one intramural perforation by a ureteric catheter and two extravasations of irrigation fluid one of which necessitated intensive care. Most of the renal and upper ureteric stones have now been successfully removed percutaneously with good patient tolerance.

Female↗
PubMed1987

Local hemostasis of nephrostomy tract with fibrin adhesive sealing in percutaneous nephrolithotomy.

In 26 patients percutaneous nephrolithotomy was carried out under local anesthesia with systemic sedation. Instead of the 25-French nephrostomy catheter used so far, a 5- or 10-French nephrostomy catheter prepared with a collagen-fibrin adhesive sealant was introduced into the nephrostomy tract. In all cases, excellent hemostasis was attained with the fibrin glue. In applying a fibrin glue, the danger of protracted venous or arterial hemorrhage from the parenchymal canal can be markedly reduced; the large-lumen nephrostomy catheter can also be dispensed with.

Aprotinin↗
PubMed1992

Long-term comparison of renal function in patients with solitary kidneys and/or moderate renal insufficiency undergoing extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy.

We compared the long-term effects of extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy monotherapy on renal function in 31 patients with a solitary kidney and/or chronic renal insufficiency who were all more than 2 years after treatment (mean 41.5 months). The change in the reciprocal of serum creatinine was used as an index to estimate changes in the glomerular filtration rate. A change of 20% or greater in the glomerular filtration rate was considered a clinically significant deterioration of renal function. The rate of deterioration of renal function in patients with a solitary kidney and creatinine of less than 2 mg./dl. was 22% for ESWL and 29% for percutaneous nephrolithotomy, respectively. All patients with a creatinine between 2 and 3 mg./dl. demonstrated long-term improvement of renal function regardless of the treatment modality. All 4 patients with creatinine greater than 3 mg./dl. undergoing ESWL had short-term improvement but eventual long-term deterioration of renal function. Indeed, 3 of these patients required dialysis within 2 years from the treatment dates. One patient with creatinine greater than 3 mg./dl. who underwent percutaneous nephrolithotomy demonstrated stabilization of the renal function after treatment. From our data, no convincing evidence could be found to suggest that ESWL results in long-term deterioration of renal function in patients with chronic renal insufficiency or a solitary kidney. We conclude that the choice between ESWL and percutaneous nephrolithotomy should be based on the stone composition, stone location and stone burden, rather than on the preexisting renal function or presence of a solitary kidney.

Adult↗
PubMed1990

Criteria audit of percutaneous nephrolithotomies.

A criteria audit of percutaneous nephrolithotomy management is reported. One hundred consecutive patients who underwent percutaneous stone removal over a 3-year period were examined. An analysis of the cases of this relatively new surgical procedure are presented. The audit demonstrated the surgeons' learning curve, the current standards achieved and changes in patient admission rate. Criteria auditing was used and assessed as a quality assurance activity.

Adolescent↗
PubMed1991

Percutaneous nephrolithotomy for calculi in horseshoe kidneys.

Between 1983 and 1988, 15 patients (18 kidneys) underwent percutaneous nephrolithotomy at this unit for calculi in horseshoe kidneys. A standard 1-stage percutaneous access technique with minor modifications was used. In situ disintegration with ultrasound or electrohydraulic lithotripsy was necessary in 15 moieties (83.3%) and nephrostomy drainage was required in 12 (66.7%). Percutaneous access was not a problem and there were minimal perioperative problems. Blood transfusion was required postoperatively in 2 patients. A total of 14 kidneys (77.8%) were rendered free of stone with percutaneous nephrolithotomy alone and 2 kidneys were left with asymptomatic stone fragments of 2 mm. or less. Another 2 kidneys became free of stone after extracorporeal shock wave lithotripsy, thus giving an over-all stone clearance rate of 88.8%. We conclude that percutaneous nephrolithotomy is an acceptable treatment for stones in horseshoe kidneys and it is the treatment of choice for patients in whom imaging is difficult or impossible.

Adult↗
PubMed1991

Percutaneous nephrolithotomy and the solitary kidney.

We reviewed 53 patients with stones in a solitary kidney who had undergone percutaneous nephrolithotomy. Previous surgery on that kidney had been performed in 35.8%, and 50.9% had other medical conditions including 26.4% who had impaired renal function. Staghorn or partial staghorn calculi were present in 52.9% and an additional 18.8% had multiple stones. Postoperative complications in 18.8% of the patients included sepsis, the need for transfusion and 1 death of bronchopneumonia. Percutaneous nephrolithotomy alone resulted in a 77.3% rate free of stone or fragments of 2 mm, or less. This rate increased to 86.8% with the addition of extracorporeal shock wave lithotripsy, ureteroscopy or open surgery (2 patients). Only 1 patient suffered long-term deterioration in renal function. Percutaneous nephrolithotomy is a safe procedure in the solitary kidney. It should be considered in those patients with complex stone burdens and impaired renal function when reduction in stone bulk and improved renal function may allow other treatment modalities to be used.

Female↗
PubMed1992

Effect of percutaneous nephrolithotomy on thermoregulation.

Hypothermia is a well recognised complication of open surgery. We had observed hypothermia, occasionally followed by rebound hyperthermia in the early post-operative period, in patients undergoing percutaneous nephrolithotomy, and therefore decided to monitor patients undergoing this procedure more closely. During a 12-month period, 32 patients were monitored during 38 percutaneous nephrolithotomies; 12 procedures were performed using irrigation fluid at room temperature (22 degrees C) and 26 with fluid warmed to 37 degrees C. Although no statistically significant differences between temperature changes were seen, the most profound temperature falls occurred in patients who received fluid at room temperature. The recovery ward staff observed improved post-operative recovery in patients who had received warmed fluid. Three of the 5 patients who underwent more than 1 percutaneous procedure received fluid at 22 degrees C and fluid at 37 degrees C on separate occasions. In each patient a more profound temperature fall occurred when the cold fluid was used. Only 1 patient, who received cold fluid, developed rebound hyperthermia in the early post-operative period. Warming of irrigation fluid and close monitoring of core temperature may prevent unnecessary morbidity in patients undergoing percutaneous nephrolithotomy.

Adult↗
PubMed2026

Retrograde intrarenal surgery with flexible and navigable suction access sheaths vs mini-percutaneous nephrolithotomy for large upper urinary tract stones: a systematic review and meta-analysis.

OBJECTIVE: To conduct a meta-analysis comparing the efficacy and perioperative outcomes of contemporary flexible and navigable suction access sheath-assisted retrograde intrarenal surgery (FANS-RIRS) against percutaneous nephrolithotomy (PCNL) for the management of large upper urinary tract stones, as despite technological advances in RIRS such as high-powered lasers and FANS that have substantially enhanced its performance, current guidelines continue to recommend PCNL as first-line treatment for renal stones >2cm. METHODS: MEDLINE, Embase, and the Cochrane Library were searched for studies performing direct comparisons of FANS-RIRS against PCNL in adult patients until September 2025. Primary outcomes included stone-free rates (SFRs) and need for ancillary procedures. Secondary outcomes included operative time, length of postoperative hospitalisation, and postoperative complications. RESULTS: A total of 10 studies (three randomised control trials, seven retrospective cohort studies) comprising 2347 patients were included; preoperative stone sizes were predominantly 2-3 cm. All PCNL procedures in the studies included were performed as mini-PCNL. The SFRs for FANS-RIRS were comparable with mini-PCNL across all stone sizes (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.70-1.17) and stones ≥2 cm (OR 0.80, 95% CI 0.60-1.08), with low heterogeneity. Ancillary procedures rates were similar (OR 1.22, 95% CI 0.61-2.44). FANS-RIRS was associated with significantly fewer overall complications, specifically smaller haemoglobin decline, need for transfusion, and shorter hospital stay. However, mini-PCNL demonstrated shorter operative times for stones ≥2 cm. Urosepsis rates were low and similar between both groups. Limitations include predominance of Asian studies, variability of practice, and inclusion of non-randomised studies. CONCLUSIONS: Contemporary FANS-RIRS achieves SFRs comparable to mini-PCNL even for 2-3 cm stones, while offering superior safety profiles and shorter hospitalisation; this supports FANS-RIRS as a viable primary treatment in selected patients.

Humans↗
PubMed1990

Percutaneous nephrolithotomy: spinal cord injury vs. ambulatory patients.

One hundred patients, 35 with spinal cord injury (SCI) and 65 who were ambulatory, underwent percutaneous nephrolithotomy (PNL). Success of complete stone excision, operative morbidity and mortality were compared in the two patient populations. Stone size and complexity were evaluated by X-ray and a single-stage PNL was done using general anesthesia, bi-planar C-arm fluoroscopy, Amplatz renofascial dilators, and two guide wires. Eleven percent of the patients had previously-placed percutaneous nephrostomy tubes for hydronephrosis and/or pyonephrosis. In the ambulatory group, 98.5% (64/65) were stone-free after the procedure as compared to 85.7% (31/35) in the SCI group. The success rate in those patients who followed postoperative instructions exceeded 96% in both groups of patients. One operative mortality, related to infectious complications, occurred in the SCI group. Major morbidity in the SCI population consisted of three perirenal abscesses, a hydrothorax, an aspiration pneumonia, a respiratory arrest and a nephro-colonic fistula for a rate of 20% (7/35), or 7% of all patients. One major complication, a nephroduodenal fistula, occurred in the ambulatory population. Four patients, three of whom were SCI, required open surgery related to infectious complications. Other significant complications consisted of hemorrhage requiring transfusion, and fever (101.5 degrees F). Minor complications included dislodged nephrostomy tubes, retained stones, and ureteral edema causing obstruction. These complications were three times more common in the SCI population. Percutaneous nephrolithotomy is an effective surgical means for stone removal for SCI and ambulatory patients. The SCI patient has a high incidence of infectious complications causing increased morbidity and mortality.

Adult↗
PubMed1989

[A study on acute renal damage from percutaneous nephrolithotomy assessed by urinary NAG and gamma-GTP activities].

We performed percutaneous nephrolithotomy (PNL) on 49 patients between May, 1986 and March, 1987. To investigate acute renal damage from PNL, we measured urinary NAG (N-acetyl-beta-D-glucosaminidase) and gamma-GTP (gamma-glutamyl transpeptidase) activities before PNL and for 6 days after PNL in 24 patients. The NAG activities elevated beyond normal level in 23 patients and gamma-GTP activities in 15 patients. NAG activities showed a peak level in the third day after PNL and gamma-GTP activities in the next day of PNL. After the peak both enzyme activities got down gradually. There was no difference in NAG and gamma-GTP activities between nephrostomy and lithotripsy in 2 staged patients. And the intrapelvic pressure during operation was at the normal level in 5 patients. Therefore, we think that the cause of NAG and gamma-GTP activity elevation is a mechanical damage, not an influence of the irrigation fluid. Large stones, long operation time and 2 stage procedure were the factors that produced high enzyme activities, because, we guess, the frequency of mechanical damages to the kidney increase in such cases. Postoperative pyrexia caused a slight increase in enzyme activities but preoperative hydronephrosis exerted no influence on both enzyme activities. We also measured creatinine clearance before and after PNL but no significant change was obtained. PNL causes only slight mechanical damage to the operated kidney which is reversible when assessed by NAG and gamma-GTP activities and the glomerular function is not affected. Therefore, we conclude that PNL is a safe treatment for upper urinary tract stones.

Acetylglucosaminidase↗
PubMed1991

Percutaneous nephrolithotomy--the birth of a new technique.

Extraction of renal calculi via a percutaneous track was for the first time practised at the Karolinska Hospital in 1973. After very strict indications in the beginning because of fear of uncontrollable bleeding, the method was found to be safe and the technique was spread all over the world. Now being to a large extent replaced by extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PNL) has still many applications e.g. alone in obstructed kidneys or together with ESWL in staghorn calculi.

History, 20th Century↗
PubMed1992

Cost effectiveness of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy for medium-sized kidney stones. A randomised clinical trial.

To evaluate percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (ESWL) for their clinical effects, their cost effectiveness, their complication rates, and the patients' experiences, 55 consecutive patients were randomised to have one or other operation between October 1986 and October 1988. Six patients were excluded, 21 were treated with PNL and 28 with ESWL as primary treatment. Mean hospital stay and length of treatment were longer for PNL than for ESWL. Since 1 July 1987 all patients having ESWL have been treated without anaesthesia (n = 15), whereas epidural anaesthesia was used for all PNL. Slightly more of the ESWL patients experienced some pain during treatment. Minor complications or pain were more common after ESWL during the first 10 days after discharge from hospital. If patients with stone fragments of 4 mm or less were regarded as having a successful outcome, the success rates after one year were 94% for PNL and 77% for ESWL. The overall total cost was lower for ESWL than for PNL, the cost per successfully treated patient being 2172 pounds for PNL and 1810 pounds for ESWL. Medium sized kidney stones (6-30 mm, or 2-3 stones of 20 mm or less) can be efficiently and cheaply treated by both PNL and ESWL, though the cost of ESWL is lower. Even if effects other than cost (such as complications and patients' experience) are borne in mind, ESWL was superior to PNL for this group of patients.

Cost-Benefit Analysis↗
PubMedDate not supplied

[Peroperative complications during percutaneous nephrolithotomy].

Two hundred seventy patients undergoing resection of renal or lumbar ureteral stones with percutaneous nephrolithotomy (PNL) were reviewed. The observed complications were of three types: circulatory, respiratory and metabolic (reabsorption syndrome). The rate of patients with any complication was 38.9% (104 patients). The most common type were circulatory complications, found in 75 patients (27.7%). Respiratory complications developed in 22 patients (8.1%), and the remaining 2 patients (0.74%) had reabsorption syndrome. Six cases of severe complications developed (2.22%), i.e.: one electromechanical dissociation, one ventricular tachycardia, one reabsorption syndrome and two severe difficulties for ventilation. In addition, one patient died (0.37%).

Adolescent↗