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Renal puncture access via a nonpapillary track in percutaneous nephrolithotomy: an in vitro porcine kidney experience

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Abstract

Recently, an increasing number of investigators have debated the wide rule of the puncture to renal papilla in PCNL. We evaluated the effect of renal papillary and nonpapillary puncture on bleeding in an in vitro porcine kidney experience, with the aim of determining the safe puncture sites of collecting system in PCNL. A total of 70 fresh porcine kidneys were selected and subjected to nephrostomy. We performed a puncture through a renal papilla, infundibulum, renal column, or minor calyceal neck (including the front, back, up, and down). The primary outcome was the amount of bleeding. The results showed that the papillary puncture group yielded minimal bleeding (1.59 ± 1.01 ml/min) compared with the infundibular puncture group (6.25 ± 4.46 ml/min, P < .001), renal column puncture group (4.24 ± 3.79 ml/min, P = 0.001), and minor calyceal neck puncture group (2.27 ± 1.35 ml/min, P = 0.011). However, after stratifying by orientation, the up (1.75 ± 0.80 ml/min, P = 0.501) or down (1.77 ± 0.72 ml/min, P = 0.437) minor calyceal neck puncture group and papillary puncture group yielded comparable bleeding. In summary, nonpapillary puncture must be carefully considered. Infundibular and renal column punctures were inferior to papillary puncture, and up or down minor calyceal neck puncture may be a prudent choice in specific situations.

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Data are available with permission from the corresponding author.

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Abbreviations

PCNL:

Percutaneous nephrolithotomy

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Acknowledgements

The authors thank Mrs Zefang Guo, a member of the staff of Chunran Food Co., Ltd, Hefei. She provided us with pig kidneys. This study was supported by the National Natural Science Foundation of China (82070724) and the Natural Science Foundation of Anhui Province (1908085MH246).

Funding

This work was supported by the National Natural Science Foundation of China (82070724) and the Natural Science Foundation of Anhui Province (1908085MH246).

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Authors and Affiliations

  1. Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China

    Bingbing Hou, Ziyan Song, Qiushi He & Zongyao Hao

  2. Institute of Urology, Anhui Medical University, Hefei, China

    Bingbing Hou, Ziyan Song, Qiushi He & Zongyao Hao

  3. Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China

    Bingbing Hou, Ziyan Song, Qiushi He & Zongyao Hao

  4. Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China

    Mingquan Wang

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  1. Bingbing Hou
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  2. Mingquan Wang
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  3. Ziyan Song
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  4. Qiushi He
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  5. Zongyao Hao
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by HB, WM, SZ, QH, and HZ. The first draft of the manuscript was written by HB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zongyao Hao.

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The authors declare that they have no conflict of interest.

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All animal experiments were conducted following the national guidelines and the relevant national laws on the protection of animals, and were approved by the Ethics Committee of Anhui Medical University (No. LLSC20211053).

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Hou, B., Wang, M., Song, Z. et al. Renal puncture access via a nonpapillary track in percutaneous nephrolithotomy: an in vitro porcine kidney experience. Urolithiasis 50, 357–360 (2022). https://doi.org/10.1007/s00240-022-01302-9

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  • DOI: https://doi.org/10.1007/s00240-022-01302-9

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