Double-sheath Vacuum Suction Versus Vacuum-assisted Sheath Minimally Invasive Percutaneous Nephrolithotomy for Management of Large Renal Stones: Single-center Experience

Overview

Journal World J Urol

Specialty Urology

Date 2021 May 25

PMID 34032912

Citations 2

Authors

Zhong-Hua Wu

Tong-Zu Liu

Xing-Huan Wang

Yong-Zhi Wang

Hang Zheng

Yin-Gao Zhang

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare double-sheath vacuum suction minimally invasive percutaneous nephrolithotomy (DS-mini-PCNL) with vacuum-assisted mini-PCNL (VS-mini-PCNL) and to better define the potential benefits of DS-mini-PCNL.

Methods: Between July 2019 and May 2020, 117 patients with large radiopaque renal stones underwent mini-PCNL. Of these, 63 underwent DS-mini-PCNL and 54 underwent VS-mini-PCNL. For VS-mini-PCNL, a F20 Y-shaped sheath was used and the oblique arm of the sheath was connected to the vacuum suction. For DS-mini-PCNL, the oblique arm of a F20 Y-shaped sheath (the outer sheath) and a F16 Y-shaped sheath (the inner sheath) was connected to the perfusion inflow and the vacuum suction, respectively. A 550-μm holmium-YAG laser was used for stone fragmentation.

Results: Compared with VS-mini-PCNL group, DS-mini-PCNL group had significantly shorter operative time (35.78 ± 7.77 min vs. 44.56 ± 13.19 min; P = 0.000) and significantly lower fever rate (1.6% vs. 11.1%; P = 0.048). It was not significantly different between the two groups despite the higher initial stone-free rate seen for DS-mini-PCNL group relative to VS-mini-PCNL group (87.7% vs. 81.5%, P = 0.346). Auxiliary procedure rates were 4.8% (three patients) in DS-mini-PCNL group and 16.7% (nine patients) in VS-mini-PCNL group, with a significant difference (P = 0.034). The difference in the final stone-free rate between the two groups was rendered insignificant (93.8% vs. 89.1%, P = 0.510).

Conclusions: DS-mini-PCNL is a safe and effective modality for large renal stones, which could increase the efficiency of stone extraction and decrease infectious complications compared with VS-mini-PCNL.

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References

Ghani K, Andonian S, Bultitude M, Desai M, Giusti G, Okhunov Z . Percutaneous Nephrolithotomy: Update, Trends, and Future Directions. Eur Urol. 2016; 70(2):382-96. DOI: 10.1016/j.eururo.2016.01.047. View

Seitz C, Desai M, Hacker A, Hakenberg O, Liatsikos E, Nagele U . Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol. 2011; 61(1):146-58. DOI: 10.1016/j.eururo.2011.09.016. View

Ruhayel Y, Tepeler A, Dabestani S, MacLennan S, Petrik A, Sarica K . Tract Sizes in Miniaturized Percutaneous Nephrolithotomy: A Systematic Review from the European Association of Urology Urolithiasis Guidelines Panel. Eur Urol. 2017; 72(2):220-235. DOI: 10.1016/j.eururo.2017.01.046. View

Yamaguchi A, Skolarikos A, Buchholz N, Bueno Chomon G, Grasso M, Saba P . Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol. 2011; 25(6):933-9. DOI: 10.1089/end.2010.0606. View

Abdelhafez M, Bedke J, Amend B, ElGanainy E, Aboulella H, Elakkad M . Minimally invasive percutaneous nephrolitholapaxy (PCNL) as an effective and safe procedure for large renal stones. BJU Int. 2012; 110(11 Pt C):E1022-6. DOI: 10.1111/j.1464-410X.2012.11191.x. View

Lahme S, Bichler K, Strohmaier W, Gotz T . Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol. 2002; 40(6):619-24. DOI: 10.1159/000049847. View

Cheng F, Yu W, Zhang X, Yang S, Xia Y, Ruan Y . Minimally invasive tract in percutaneous nephrolithotomy for renal stones. J Endourol. 2010; 24(10):1579-82. DOI: 10.1089/end.2009.0581. View

Wu C, Hua L, Zhang J, Zhou X, Zhong W, Ni H . Comparison of renal pelvic pressure and postoperative fever incidence between standard- and mini-tract percutaneous nephrolithotomy. Kaohsiung J Med Sci. 2017; 33(1):36-43. DOI: 10.1016/j.kjms.2016.10.012. View

Zhu W, Liu Y, Liu L, Lei M, Yuan J, Wan S . Minimally invasive versus standard percutaneous nephrolithotomy: a meta-analysis. Urolithiasis. 2015; 43(6):563-70. DOI: 10.1007/s00240-015-0808-y. View

10.

Giusti G, Piccinelli A, Taverna G, Benetti A, Pasini L, Corinti M . Miniperc? No, thank you!. Eur Urol. 2006; 51(3):810-4. DOI: 10.1016/j.eururo.2006.07.047. View

11.

Ganpule A, Bhattu A, Desai M . PCNL in the twenty-first century: role of Microperc, Miniperc, and Ultraminiperc. World J Urol. 2014; 33(2):235-40. DOI: 10.1007/s00345-014-1415-1. View

12.

Torricelli F, Vicentini F, Zanetti L, Perrella R, Marchini G, Danilovic A . Percutaneous nephrolithotomy in patients with spinal cord injury: should all these patients be automatically assigned a Guy's stone score of 4?. World J Urol. 2020; 39(6):2129-2134. DOI: 10.1007/s00345-020-03443-1. View

13.

Lai D, Chen M, Sheng M, Liu Y, Xu G, He Y . Use of a Novel Vacuum-Assisted Access Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Feasibility Study. J Endourol. 2020; 34(3):339-344. DOI: 10.1089/end.2019.0652. View

14.

Shah D, Patil A, Reddy N, Singh A, Ganpule A, Sabnis R . A clinical experience of thulium fibre laser in miniperc to dust with suction: a new horizon. World J Urol. 2020; 39(7):2727-2732. DOI: 10.1007/s00345-020-03458-8. View

15.

Knoll T, Daels F, Desai J, Hoznek A, Knudsen B, Montanari E . Percutaneous nephrolithotomy: technique. World J Urol. 2017; 35(9):1361-1368. DOI: 10.1007/s00345-017-2001-0. View

16.

Nicklas A, Schilling D, Bader M, Herrmann T, Nagele U . The vacuum cleaner effect in minimally invasive percutaneous nephrolitholapaxy. World J Urol. 2015; 33(11):1847-53. DOI: 10.1007/s00345-015-1541-4. View

17.

Mager R, Balzereit C, Gust K, Husch T, Herrmann T, Nagele U . The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model. World J Urol. 2015; 34(5):717-24. DOI: 10.1007/s00345-015-1682-5. View

18.

Suer E, Karaburun M, Babayigit M, Akpinar C, Gokce M, Gulpinar O . Does Switching Bacillus Calmette-Guerin Strains During Maintenance Therapy Affect the Outcome in Non-Muscle Invasive Bladder Cancer?. Urology. 2021; 158:135-141. DOI: 10.1016/j.urology.2021.08.008. View

19.

Zeng G, Zhu W, Liu Y, Fan J, Zhao Z, Cai C . The new generation super-mini percutaneous nephrolithotomy (SMP) system: a step-by-step guide. BJU Int. 2017; 120(5):735-738. DOI: 10.1111/bju.13955. View

20.

Peng L, Pan J, Yang D, Zhong W . The prospect of machine learning in predicting post-lithotripsy outcomes. World J Urol. 2020; 39(11):4287-4288. DOI: 10.1007/s00345-020-03377-8. View