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Ambulatory second look percutaneous nephrolithotripsy with maturated nephrostomy tract

Title
Ambulatory second look percutaneous nephrolithotripsy with maturated nephrostomy tract
Authors
Yoon H.S.Song W.Kim K.H.Yoon H.Lee D.H.Chung W.S.Shim B.S.Son J.H.
Ewha Authors
심봉석정우식이동현윤하나김광현송완윤현석
SCOPUS Author ID
심봉석scopusscopus; 정우식scopus; 이동현scopus; 윤하나scopus; 김광현scopusscopus; 송완scopus; 윤현석scopusscopus
Issue Date
2020
Journal Title
International Braz J Urol
ISSN
1677-5538JCR Link
Citation
International Braz J Urol vol. 46, no. 4, pp. 676 - 676
Publisher
Brazilian Society of Urology
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Introduction and Objectives: Percutaneous nephrolithotomy (PCNL) is the standard technique for managing large renal calculi. Second-look PCNL is typically performed under intravenous (IV) sedation or spinal/general anesthesia when removing remnant stones. This requires additional pre-anesthesia assessment and close monitoring. To simplify this procedure, we investigated the feasibility and safety of second-look PCNL without anesthesia and sheath after maturation of the nephrostomy tract. Material and Methods: This study included 14 eligible patients with remnant stones >5mm in diameter, as determined by simple CT scan after supine PCNL through a single nephrostomy tract under general anesthesia. A 24Fr nephrostomy tube was inserted after surgery. Second-look PCNL was performed after seven days of maturation of the nephrostomy tract. Prior to second-look surgery, 25mg pethidine was injected intravenously. Second-look supine PCNL was performed using a rigid or flexible renoscope without anesthesia or sheath. Results: The mean patient age was 57.4±8.5 years. The mean stone diameter was 5.4 x 3.3cm, while the mean number of stone branches was 4.1±1.4. The mean operation time during the first PCNL was 131.1±24.8 min, and the mean residual stone rate was 24.3%±10.2%. The mean operation time during second-look PCNL was 97.4±36.0 min; after the second procedure, the mean pain score on the numeric rating scale was 2.8±1.0. All patients were stone-free without complications. Conclusion: Second-look PCNL without anesthesia and sheath after maturation of the nephrostomy tract may be an effective procedure for removing remnant stones in select patients without excessive levels of pain. © 2019, Brazilian Society of Urology.
DOI
10.1590/S1677-5538.IBJU.2019.0003
Appears in Collections:
의과대학 > 의학과 > Journal papers
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