Efficacy and Safety of Kumpe Access Catheter for Pre-percutaneous Nephrolithotomy Renal Access in Modified Supine Percutaneous Nephrolithotomy

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2023 Jun 15

PMID 37322432

Authors

Jun-Koo Kang

Sang Hee Lee

Seok-Gi Kim

Ju-Bin Kim

Jeong-Yeon Lee

Seon-Yeon Ha

Chan-Geun Ha

Soon-Ho Hong

Jae-Wook Chung

Yun-Sok Ha

Jun Nyung Lee

So Young Chun

Bum Soo Kim

Affiliations

Soon will be listed here.

Abstract

Introduction: Traditionally, a pigtail catheter (PCN) is placed for preoperative renal access before performing percutaneous nephrolithotomy (PCNL). However, PCN can hamper the passage of the guidewire to the ureter, due to which, access tract can be lost. Therefore, Kumpe Access Catheter (KMP) has been proposed for preoperative renal access before PCNL. In this study, we analyzed the efficacy and safety of KMP for surgical outcomes in modified supine PCNL compared to those in PCN.

Materials And Methods: From July 2017 to December 2020, 232 patients underwent modified supine PCNL at a single tertiary center, of which 151 patients were enrolled in this study after excluding patients who underwent bilateral surgery, multiple punctures, or combined operations. Enrolled patients were divided into two groups according to the type of pre-PCNL nephrostomy catheter used: PCN versus KMP. A pre-PCNL nephrostomy catheter was selected based on the radiologist's preference. A single surgeon performed all PCNL procedures. Patient characteristics and surgical outcomes, including stone-free rate, operation time, radiation exposure time (RET), and complications, were compared between the two groups.

Results: Of the 151 patients, 53 underwent PCN placement, and 98 underwent KMP placement for pre-PCNL nephrostomy. Patient baseline characteristics were comparable between the two groups, except for the renal stone type and multiplicity. The operation time, stone-free rate, and complication rate were not significantly different between the two groups; however, RET was significantly shorter in the KMP group.

Conclusion: The surgical outcomes of KMP placement were comparable to those of PCN and showed shorter RET during modified supine PCNL. Based on our results, we recommend KMP placement for pre-PCNL nephrostomy, particularly for reducing RET during supine PCNL.

References

Valdivia J, Scarpa R, Duvdevani M, Gross A, Nadler R, Nutahara K . Supine versus prone position during percutaneous nephrolithotomy: a report from the clinical research office of the endourological society percutaneous nephrolithotomy global study. J Endourol. 2011; 25(10):1619-25. DOI: 10.1089/end.2011.0110. View

Jung H, Seo I, Lee J . Large database study of urinary stone composition in South Korea: Korean Society of Endourology and Robotics (KSER) research series. Investig Clin Urol. 2021; 62(4):462-469. PMC: 8246010. DOI: 10.4111/icu.20210039. View

Zhao Z, Wu W, Zeng T, Wu X, Liu Y, Zeng G . The impact of nephrostomy drainage prior to mini-percutaneous nephrolithotomy in patients with ESBL-positive Escherichia coli. World J Urol. 2020; 39(1):239-246. DOI: 10.1007/s00345-020-03155-6. View

Ibarluzea G, Scoffone C, Cracco C, Poggio M, Porpiglia F, Terrone C . Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int. 2007; 100(1):233-6. DOI: 10.1111/j.1464-410X.2007.06960.x. View

Choo M, Cho S . The era of robotic flexible ureteroscopic management of urinary calculi and the domain of 'surgeons' in the endoscopic surgical procedures. Investig Clin Urol. 2022; 63(6):589-591. PMC: 9643728. DOI: 10.4111/icu.20220272. View

Valdivia Uria J, Valle Gerhold J, Lopez Lopez J, Villarroya Rodriguez S, Ambroj Navarro C, Ramirez Fabian M . Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol. 1998; 160(6 Pt 1):1975-8. DOI: 10.1016/s0022-5347(01)62217-1. View

Cracco C, Scoffone C, Poggio M, Scarpa R . The patient position for PNL: does it matter?. Arch Ital Urol Androl. 2010; 82(1):30-1. View

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

Gofrit O, Shapiro A, Donchin Y, Bloom A, Shenfeld O, Landau E . Lateral decubitus position for percutaneous nephrolithotripsy in the morbidly obese or kyphotic patient. J Endourol. 2002; 16(6):383-6. DOI: 10.1089/089277902760261437. View

10.

Saussine C, Lechevallier E, Traxer O . [Tubeless PCNL]. Prog Urol. 2008; 18(12):901-7. DOI: 10.1016/j.purol.2008.09.045. View

11.

Bearelly P, Lis C, Trussler J, Katz M, Babayan R, Wang D . Nephrostomy tube placement prior to percutaneous nephrolithotomy does not impact outcomes. Can J Urol. 2018; 25(5):9497-9502. View

12.

Benson A, Juliano T, Miller N . Infectious outcomes of nephrostomy drainage before percutaneous nephrolithotomy compared to concurrent access. J Urol. 2014; 192(3):770-4. DOI: 10.1016/j.juro.2014.03.004. View

13.

FERNSTROM I, Johansson B . Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976; 10(3):257-9. DOI: 10.1080/21681805.1976.11882084. View

14.

Lehman T, Bagley D . Reverse lithotomy: modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology. 1988; 32(6):529-31. DOI: 10.1016/s0090-4295(98)90035-8. View

15.

Chung J, Ha H, Park D, Ha Y, Lee J, Chun S . Efficacy and safety of modified tract dilation technique using simultaneous pulling of proximal and distal ends of a guidewire for percutaneous nephrolithotomy in modified supine position. Investig Clin Urol. 2021; 62(2):186-194. PMC: 7940847. DOI: 10.4111/icu.20200276. View