PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “percutaneous nephrolithotomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2006

Renal pseudoaneurysm following percutaneous nephrolithotomy.

Percutaneous renal surgery can be utilized as treatment for a variety of urologic conditions. Percutaneous nephrolithotomy remains the treatment of choice for many large and complex renal calculi. Despite having a low overall complication rate, postoperative bleeding can occur. We report a case of significant hemorrhage from a renal pseudoaneurysm in a patient requiring anticoagulation following percutaneous nephrolithotomy. The bleeding was controlled by percutaneous coil embolization. Current management recommendations of postoperative hemorrhage following percutaneous renal surgery are reviewed.

Aneurysm, False↗
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↗
PubMed1997

The Hickman peel-away sheath: alternative for pediatric percutaneous nephrolithotomy.

Percutaneous nephrolithotomy presents a therapeutic challenge in children because of the disproportion between the sizes of the instruments and the kidneys. A technique for pediatric nephrolithotomy used on a 2-year-old female child is presented. The patient was born prematurely and developed kidney stones as a complication of furosemide therapy. She failed medical management with hydrochlorothiazide, and the stone did not disintegrate following extracorporeal shockwave lithotripsy (ESWL). A Chiba needle was used to access the renal collecting system percutaneously. Using a guidewire, sequential dilatation was performed to 16F. A 15F Hickman catheter introduction kit was then used, and the sheath was partially peeled away. A 10F pediatric cystoscope and grasper were inserted through the sheath to remove the stones. A 12F catheter was then placed through the sheath; the sheath was peeled away, and the catheter was left indwelling for 48 hours. No complications ensued. A postoperative nephrostogram showed free drainage and absence of residual stones. Utilization of the Hickman peel-away sheath constitutes an excellent alternative nephrolithotomy technique for children with stones unresponsive to more conservative treatment.

Catheters, Indwelling↗
PubMed1988

The use of noxythiolin (Noxyflex 'S') as an antiseptic irrigant in upper urinary tract drainage following percutaneous nephrolithotomy.

Percutaneous nephrostomy drainage for the relief of obstruction or stone removal has become a common procedure. Despite the routine use of prophylactic antibiotics, nephrostomy urine frequently becomes infected (approximately 30% of cases). Noxythiolin irrigation has been used to prevent and treat bladder infections. A double-blind, placebo controlled study was carried out in 20 patients undergoing a single-stage percutaneous nephrolithotomy to evaluate the use of noxythiolin as an upper urinary tract antiseptic. In the patients whose nephrostomy tubes were irrigated with a 2.5% solution of noxythiolin, significant bacterial infection was eliminated from the nephrostomy urine and colonisation of the catheter tip was markedly reduced. Noxythiolin also rendered pre-operative infected bladder urine sterile. There were no untoward local or systemic sequelae in either group of patients. This study indicates that irrigation of the upper urinary tract with noxythiolin solution is safe and may be a useful adjunct to reduce the risk of sepsis in patients undergoing percutaneous drainage procedures.

Adolescent↗
PubMed2003

Massive intraabdominal extravasation of fluid: a life threatening complication following percutaneous nephrolithotomy.

Percutaneous nephrolithotomy provides an attractive alternative to the surgical removal of renal stones as it is associated with reduced patient morbidity and shortened hospital stay. The advantages of this procedure may, however, be overshadowed by complications like bleeding, extravasation of irrigant fluid and infection, which can be life threatening. We report a case of massive extravasation of irrigant fluid producing severe metabolic acidosis, persistent peritonism and ileus leading to a prolonged hospital stay. The patient also required a further surgery for the complete removal of the stones.

Adult↗
PubMed1983

Percutaneous nephrolithotomy.

Percutaneous nephrolithotomy is becoming an established technique for the surgical management of renal stones. In a series of 48 patients treated by this method a success rate of 89% was achieved after an initial learning phase. The technique is suitable to be practised in any Department of Urology.

Adult↗
PubMed1987

An alternative approach to tract dilation using optic urethrotome in percutaneous nephrolithotomy.

Percutaneous removal of renal or ureteral calculi requires fluoroscopic guidance of nephrostomy tube insertion, tract dilation and stone manipulation. We introduce an effective method of nephrostomy tract dilation with optic urethrotomy under direct visual control, which protects the patient and medical personnel from fluoroscopic exposure without further increasing the incidence of immediate and delayed vascular complications. In our series of 70 patients (73 kidneys) only 1 (1.4 per cent) had hypovolemic shock, with no kidney loss or operative mortality encountered. Of the kidneys 69 were operated on in 1 and 4 in 2 sessions. There was only 1 failure, for a success rate of 98.6 per cent and the stones were reached in all cases.

Adult↗
PubMed1984

[Percutaneous nephrolithotomy].

Percutaneous removal of renal and ureteral stones was attempted in 19 cases through an operatively established nephrostomy tract and in 181 cases after primary percutaneous puncture. In the latter group failure of the technique or residual stones required surgical intervention in 15 cases. The residual stone rate was 9/19 and 13/168. The most frequently applied technique of stone removal was by ultrasound disintegration. Of 12 complications 11 were managed conservatively. A "one-step" procedure performed in the last 105 patients resulted in immediate success in 76. Secondary sessions were necessary in 29 patients. Depending on the number of sessions necessary for complete stone removal, the hospitalization time averaged 7 to 12 days.

Endoscopy↗
PubMed2005

Tubeless percutaneous nephrolithotomy. A comparative study with standard percutaneous nephrolithotomy.

INTRODUCTION: To assess the efficacy, safety and morbidity of tubeless percutaneous nephrolithotomy. MATERIALS AND METHODS: One hundred and fifty-two patients with renal and upper ureteric calculi were included in this study. Sixty-nine patients (71 renal units; group 1) in whom no nephrostomy tube was placed at the conclusion of the procedure was compared with a similar control group of 83 patients (group 2) in whom a nephrostomy tube was placed. Operating time, blood loss, analgesia requirement, puncture site urinary leakage, hospital stay and mean convalescence period were compared in both groups. RESULTS: Both groups were similar with respect to age, sex distribution and stone size. Operating time and blood loss were less in group 1 although they did not reach statistical significance. The mean analgesic requirement, puncture site urinary leakage and hospital stay were significantly less in group 1. CONCLUSION: Tubeless percutaneous nephrolithotomy is a safe and effective procedure in this selected group of patients.

Adolescent↗
PubMed2000

Mini-percutaneous nephrolithotomy.

Standard percutaneous nephrolithotomy is highly effective for the removal of renal calculi. However, significant morbidity has been associated with this procedure. Consequently, many urologists inappropriately defer to a less effective procedure to reduce patient morbidity. This practice may increase the total number of procedures needed for treatment and result in a substantial increase in health care costs. Mini-percutaneous nephrolithotomy using a 13F ureteroscopy sheath is described to reduce the morbidity associated with standard percutaneous nephrolithotomy while maintaining its efficiency and effectiveness for stone removal. The indications and technique for mini-percutaneous nephrolithotomy and our results are summarized.

Cystoscopy↗
PubMed2002

Severe renal bleeding caused by a ruptured renal sheath: case report of a rare complication of percutaneous nephrolithotomy.

BACKGROUND: Percutaneous nephrolithotomy is a minimally invasive intervention for renal stone disease. Complications, which are rare and usually presented as case reports, are diversified as the utilization of the procedure is expanded. The procedure causes less blood loss and less morbidity when compared to open surgical procedures. Yet, there are some reports involving severe bleeding and relevant morbidity during surgery. These are usually related with the surgical technique or experience of the surgeon. Renal sheaths are designed to cause minimal trauma inside the kidney and, to our knowledge, there are no reports presenting the rupture of a sheath causing severe bleeding during the procedure. CASE REPORT: We present an adult patient who had severe bleeding during percutaneous nephrolithotomy due to parenchymal injury caused by a ruptured renal sheath. During retrieval, due probably to rough handling of the equipment, a piece of stone with serrated edges ruptured the tip of the sheath, and this tip caused damage inside the kidney. The operation was terminated and measures were taken to control bleeding. The patient was transfused with a total of 1600 ml of blood, and the stones were cleared in a second look operation. CONCLUSION: Although considered to be a minimally invasive procedure, some unexpected complications may arise during percutaneous nephrolithotomy. After being fragmanted, stone pieces may damage surgical equipment, causing acute and severe harm to the kidney. Surgeons must manipulate the equipment with fine and careful movements in order to prevent this situation.

Hemorrhage↗
PubMed2006

Previous open nephrolithotomy: does it affect percutaneous nephrolithotomy techniques and outcome?

BACKGROUND AND PURPOSE: The consequences of open nephrolithotomy are scar tissue around the kidney and in the retroperitoneum and distortion of the pelvicaliceal anatomy that may affect the techniques and outcome of percutaneous nephrolithotomy (PCNL). We compared the results and complications of patients undergoing PCNL who had and had not previously undergone open nephrolithotomy. PATIENTS AND METHODS: A total of 178 calculi in 175 patients who had previously had open nephrolithotomy (group I) and 178 calculi in 175 patients who had never had a renal operation (group II) were treated with PCNL. The average time between open nephrolithotomy and PCNL was 8.5 years (range 4 months-22 years). In both groups, PCNL was done by a standard technique with serial Amplatz dilator enlargement of the tract to 30F. Upper-pole access under fluoroscopic guidance was done in most patients. The operative time, success rate, hospital stay, and complications in the two groups were compared. RESULTS: The stone-free rates were 80.3% and 82.6% in groups I and II, respectively, and the rate of residual fragments < or =4 mm was 14.6% and 8.4%. The operative time, success rate, hospital stay, and complications did not differ significantly in the two groups. CONCLUSION: Percutaneous nephrolithotomy is effective and safe in patients who have previously had open nephrolithotomy with no more complications than are seen with PCNL of kidneys that have not been operated on.

Adolescent↗
PubMed2006

Impact of percutaneous access point number and location on complication and success rates in percutaneous nephrolithotomy.

OBJECTIVES: Percutaneous nephrolithotomy (PNL) is sometimes associated with complications, especially in patients with complex stones. Herein, we review our experience with PNL to determine the impact of percutaneous access number and location on success and complication rates. PATIENTS AND METHODS: During a 2-year period, a total of 275 patients with a mean age of 42.3 +/- 14.8 (range: 13-75) years underwent PNL. Stones were classified as simple in 51.6%, and complex (staghorn calculi or renal pelvis stones coexisting with caliceal stones) in 48.4%. Percutaneous access was done under C-armed fluoroscopy and the tract was formed with a high-pressure balloon dilation system. One single percutaneous access was sufficient in 210 (76.4%), while 2 accesses were utilized in 44 (16%), and > or =3 accesses in 21 cases (7.6%). Supracostal access was performed in 23 (8.4%) patients. RESULTS: An overall success rate of 94.9% was achieved. Stone location, but not the access point location, was the major determinant for success, which was 99.3 and 90.2% in patients with simple and complex stones, respectively (p < 0.01). Significant complications included bleeding necessitating blood transfusion in 28 (10.2%), and hydropneumothorax in 2 (0.7%) patients. Bleeding was observed in 39.1 and 7.5% of patients managed with supracostal access, and subcostal access, respectively (p < 0.01). An increased number of access points significantly augmented the risk for bleeding. Bleeding was encountered in 7.6% of patients managed with 1 percutaneous access point, and in 18.5% of cases managed with > or =2 access points (p < 0.05). Hydropneumothorax occurred in patients with supracostal access. CONCLUSION: Supracostal access as well as multiple punctures may be needed especially in the management of complex stones, and the need for multiple access points and supracostal access significantly increases complication rates.

Adolescent↗
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↗
PubMed1999

Percutaneous nephrolithotomy in the pediatric population.

PURPOSE: Percutaneous nephrolithotomy is an established technique used in children with renal calculi. We review our experience with percutaneous nephrolithotomy for treating nephrolithiasis in childhood. MATERIALS AND METHODS: We retrospectively reviewed the records of children who underwent percutaneous nephrolithotomy procedures for renal calculi from 1985 to 1996. Antegrade percutaneous access was obtained in all patients and the tract was dilated to 24F. Grasper forceps, ultrasound and/or electrohydraulic lithotripsy was used to remove and disintegrate stones. In all patients a nephrostomy tube was placed intraoperatively, and a plain abdominal x-ray and nephrostogram were done postoperatively. The nephrostomy tube was removed after ensuring free drainage down the ureter and no untoward effects from clamping. Complete anatomical and metabolic evaluation was performed in all cases. Patients were followed 2 to 6 weeks, and 3 and 6 months postoperatively with a plain abdominal x-ray and excretory urography or renal ultrasound. RESULTS: In 5 boys and 3 girls (9 renal units) 4 to 11 years old (mean age 6.4) a total of 10 percutaneous nephrolithotomy procedures were performed. At presentation 6 children had flank and/or abdominal pain, 5 gross hematuria and 3 urinary tract infection. Three patients had associated metabolic abnormalities. One patient with a staghorn calculus had hydronephrosis and multiple infundibular stenoses. No underlying urological anatomical abnormalities were noted in the remaining cases. Four renal units that were obstructed at presentation required initial nephrostomy tube insertion. Average operative time was 131.8 minutes (range 58 to 240). An 87.5% stone-free rate was achieved using percutaneous nephrolithotomy monotherapy. Percutaneous nephrolithotomy was not successful for eradicating a staghorn stone in 1 patient. Hypothermia developed in 2 patients in whom operative time exceeded 150 minutes. No blood transfusions were required. CONCLUSIONS: Percutaneous nephrolithotomy is safe and effective in children, and should be considered a viable management option. However, staghorn calculi may require alternative management, particularly in the setting of underlying anatomical abnormalities. Children with renal calculi should undergo a complete anatomical and metabolic assessment with the institution of medical therapy, as appropriate.

Child↗
PubMed2003

Percutaneous nephrolithotomy: an update.

PURPOSE OF REVIEW: Percutaneous nephrolithotomy has undergone an evolution in technique and in equipment since its introduction in the late 1970s. This evolution continues today and is evidenced by the numerous publications about the technique. This review summarizes some of the important articles over the past year. RECENT FINDINGS: Although ureteroscopy and shock wave lithotripsy predominate in the treatment of urolithiasis, percutaneous nephrolithotomy continues to play an important role. Percutaneous nephrolithotomy is advantageous as it causes minimal renal injury and maximizes stone clearance, especially in patients with complex stone disease. Although nephrostomy drainage tubes have always been placed after percutaneous nephrolithotomy, there may be specific indications for tubeless percutaneous nephrolithotomy. SUMMARY: Percutaneous nephrolithotomy continues to be an important part of the urologist's armamentarium. Recent studies have redefined the role of percutaneous nephrolithotomy and future studies will further delineate the importance of this procedure in the treatment of urolithiasis.

Clinical Trials as Topic↗