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23.05.2020 | Original Article

Multiple-tract percutaneous nephrolithotomy as a day surgery for the treatment of complex renal stones: an initial experience

verfasst von: Huacai Zhu, Zhijian Zhao, Donglong Cheng, Xiangkun Wu, Gaoyuanzhi Yue, Yeci Lei, Zhilin Li, Guohua Zeng, Yongda Liu

Erschienen in: World Journal of Urology | Ausgabe 3/2021

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Abstract

Purpose

The purpose of this study was to evaluate the safety and efficiency of multiple-tract percutaneous nephrolithotomy (PCNL) as a day surgery for the treatment of complex renal stones.

Patients and methods

A mature protocol for day surgery was implemented. Forty-six patients who underwent planned day-surgery PCNL via multiple tracts for the treatment of complex renal stones were retrospectively reviewed. All procedures were performed by an experienced surgeon. The outcomes were recorded.

Results

The mean stone size and burden were 4.8 cm and 990.2 mm², respectively. There were 26 (56.5%) and 20 (43.5%) patients with staghorn stones and multiple stones, respectively. Totals of two, three, and more than three tracts (with up to 7 tracts) were established in 22, 11, and 13 patients, respectively. The tract sizes ranged from 14 to 24 Fr. One to four nephrostomy tubes were placed in most patients, and a tubeless process was accomplished in only 3 (6.5%) patients. The mean surgery time was 116 min with a hemoglobin drop of 22.1 ± 16.8 g/L. Eight (17.4%) patients developed postoperative complications, with severe complications (Clavien grades III–IV) in two cases (4.4%). 39 (84.8%) patients were discharged within 24 h after surgery, and 7 (15.2%) patients were fully admitted. Only 1 (2.2%) patient required readmission. The stone clearance rate was 84.8%.

Conclusions

Day-surgery PCNL can be safely performed via multiple percutaneous tracts by experienced surgeons and is an efficient strategy for the treatment of complex renal stones.

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Titel: Multiple-tract percutaneous nephrolithotomy as a day surgery for the treatment of complex renal stones: an initial experience
verfasst von: Huacai Zhu
Zhijian Zhao
Donglong Cheng
Xiangkun Wu
Gaoyuanzhi Yue
Yeci Lei
Zhilin Li
Guohua Zeng
Yongda Liu
Publikationsdatum: 23.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2021
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03260-6

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Multiple-tract percutaneous nephrolithotomy as a day surgery for the treatment of complex renal stones: an initial experience