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

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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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Author notes

  1. Huacai Zhu and Zhijian Zhao contributed equally to this article as the co-first authors.

Authors and Affiliations

  1. Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, Guangzhou Institute of Urology, The First Affiliated Hospital of Guangzhou Medical University, Haizhu District, Kangda Road 1#, Guangzhou, 510230, Guangdong, China

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

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  1. Huacai Zhu
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  2. Zhijian Zhao
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  3. Donglong Cheng
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  4. Xiangkun Wu
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  7. Zhilin Li
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  8. Guohua Zeng
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  9. Yongda Liu
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Contributions

Yongda Liu had full access to all the data in this study and takes responsibility for the integrity of the data and the accuracy of the data analysis. GZ and YL contribute to study concept and design. HZ, ZZ, DC, XW, GY, YL, and ZL are involved acquisition of data. HZ and ZZ contribute to analysis and interpretation of data. HZ, ZZ, and DC are involved in drafting of the manuscript. ZZ and YL perform critical revision of the manuscript for important intellectual content. HZ carries out statistical analysis. GZ and YL perform supervision. Other: None.

Corresponding author

Correspondence to Yongda Liu.

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The author(s) declare no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Zhu, H., Zhao, Z., Cheng, D. et al. Multiple-tract percutaneous nephrolithotomy as a day surgery for the treatment of complex renal stones: an initial experience. World J Urol 39, 921–927 (2021). https://doi.org/10.1007/s00345-020-03260-6

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  • DOI: https://doi.org/10.1007/s00345-020-03260-6

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