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The optical puncture combined standard percutaneous nephrolithotomy versus the conventional percutaneous nephrolithotomy for kidney stones without hydronephrosis: a comparative study

  • Nephrology - Original Paper
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Abstract

Purpose

To compare the efficacy and safety of optical puncture combined with standard percutaneous nephrolithotomy (PNL) and conventional PNL for the treatment of patients with complex kidney stones with no or mild hydronephrosis.

Methods

We retrospectively reviewed the data on patients with complex kidney stones treated by PNL in our hospital between May 2019 and February 2022. The patients were divided into two groups according to the puncture techniques applied. In the optical puncture group, 40 patients underwent optical puncture combined with standard PNL. In the control group, 44 patients underwent conventional standard PNL. The demographics and perioperative parameters were analyzed between the two groups.

Results

There mean puncture durations were significantly shorter in the optical puncture group (8.2 ± 2.16 min) than in the control group (14.0 ± 6.76 min) (P = 0.001). The re-puncture rates were lower in the optical puncture group (5%) compared with the control group (20.5%) (P = 0.036). The access loss rate in the optical puncture group (2.5%) was significantly lower than that in the control group (11.36%) (P = 0.037). The mean hemoglobin drop was significantly lower in the optical puncture group (12.6 ± 5.36 g/L) compared with the control group (22.3 ± 11.61 g/L) (P = 0.001). The mean hospital stay was significantly shorter in the optical puncture group (3.9 ± 1.65d) compared with the control group (5.1 ± 2.10d) (P = 0.042). The primary stone-free rate in the optical puncture group (87.5%) was similar to the control group (84.1%) (P = 0.656). The overall stone-free rates were 95% in the optical puncture group and 93.2% in the control group (P = 0.725). There were significantly more patients in the control group (18.2%) who suffered collecting system injury than in the optical puncture group (2.5%) (P = 0.020). There were no significant differences between the two groups in terms of blood transfusion (P = 0.292), fever (P = 0.696) and urosepsis (P = 0.946).

Conclusion

We demonstrated that optical puncture combined with standard PNL could increase the precision and success rate of puncture, and reduce the access-related complications in patients with complex kidney stones without hydronephrosis.

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References

  1. Wang W, Fan J, Huang G, Li J, Zhu X, Tian Y, Su L (2017) Prevalence of kidney stones in mainland China: a systematic review. Sci Rep 7:41630

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Liang T, Zhao C, Wu G, Tang B, Luo X, Lu S, Dong Y, Yang H (2017) Multi-tract percutaneous nephrolithotomy combined with EMS lithotripsy for bilateral complex renal stones: our experience. BMC Urol 17:15

    Article  PubMed  PubMed Central  Google Scholar 

  3. Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51:899–906 (discussion 906)

    Article  PubMed  Google Scholar 

  4. Zhou M, He X, Zhang Y, Yu W (2019) Optical puncture combined with balloon dilation PCNL vs. conventional puncture dilation PCNL for kidney stones without hydronephrosis: a retrospective study. BMC Urol 19:1–7

    Article  Google Scholar 

  5. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M (2011) The “all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol 59:1054–1059

    Article  PubMed  Google Scholar 

  6. Chen D, Jiang C, Liang X, Zhong F, Huang J, Lin Y, Zhao Z, Duan X, Zeng G, Wu W (2019) Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones. BJU Int 123:1041–1047

    Article  CAS  PubMed  Google Scholar 

  7. Somani BK, Desai M, Traxer O, Lahme S (2014) Stone-free rate (SFR): a new proposal for defining levels of SFR. Urolithiasis 42:95

    Article  PubMed  Google Scholar 

  8. Zhu H, Zhao Z, Cheng D, Wu X, Yue G, Lei Y, Li Z, Zeng G, Liu Y (2021) Multiple-tract percutaneous nephrolithotomy as a day surgery for the treatment of complex renal stones: an initial experience. World J Urol 39:921–927

    Article  PubMed  Google Scholar 

  9. Li H, Chen Y, Liu C, Li B, Xu K, Bao S (2013) Construction of a three-dimensional model of renal stones: comprehensive planning for percutaneous nephrolithotomy and assistance in surgery. World J Urol 31:1587–1592

    Article  PubMed  Google Scholar 

  10. Yu W, Rao T, Li X, Ruan Y, Yuan R, Li C, Li H, Cheng F (2017) The learning curve for access creation in solo ultrasonography-guided percutaneous nephrolithotomy and the associated skills. Int Urol Nephrol 49:419–424

    Article  PubMed  Google Scholar 

  11. Alsyouf M, Arenas JL, Smith JC, Myklak K, Faaborg D, Jang M, Olgin G, Lehrman E, Baldwin DD (2016) Direct endoscopic visualization combined with ultrasound guided access during percutaneous nephrolithotomy: a feasibility study and comparison to a conventional cohort. J Urol 196:227–233

    Article  PubMed  Google Scholar 

  12. Zhang B, Xie H, Hu Y, Liu C (2019) The visual percutaneous nephrolithotomy versus the conventional percutaneous nephrolithotomy in treatment for renal stone. Minerva Urol Nefrol 71:627–635

    Article  PubMed  Google Scholar 

  13. Ren M, Zhang C, Fu W, Fu Y, Ma L, Zhao W, Xu W, Ni S (2014) Balloon dilation versus Amplatz dilation during ultrasound-guided percutaneous nephrolithotomy for staghorn stones. Chin Med J 127:1057–1061

    PubMed  Google Scholar 

  14. Tomaszewski JJ, Smaldone MC, Schuster T, Jackman SV, Averch TD (2010) Factors affecting blood loss during percutaneous nephrolithotomy using balloon dilation in a large contemporary series. J Endourol 24:207–211

    Article  PubMed  Google Scholar 

  15. Richstone L, Reggio E, Ost MC, Seideman C, Fossett LK, Okeke Z, Rastinehad AR, Lobko I, Siegel DN, Smith AD (2008) First prize (tie): hemorrhage following percutaneous renal surgery: characterization of angiographic findings. J Endourol 22:1129–1135

    Article  PubMed  Google Scholar 

  16. Huang YS, Zhu XS, Wan GY, Zhu ZW, Huang HP (2021) Application of simulated puncture in percutaneous nephrolithotomy. Eur Rev Med Pharmacol Sci 25:190–197

    PubMed  Google Scholar 

  17. Shah AK, Xu K, Liu H, Lin T, Xie K, Huang H, Han J, Fan X, Chen J, Huang J (2013) The “visual dilator system”: initial experimental evaluation of an optical tract dilation technique in percutaneous nephrolithotomy. J Endourol 27:908–913

    Article  PubMed  Google Scholar 

  18. Chen J, Zhou X, Chen Z, Liu L, Jiang L, Chen C, Qi L, Zu X, Chen H (2014) Multiple tracts percutaneous nephrolithotomy assisted by LithoClast master in one session for staghorn calculi: report of 117 cases. Urolithiasis 42:165–169

    Article  CAS  PubMed  Google Scholar 

  19. Shalaby MM, Abdalla MA, Aboul-Ella HA, El-Haggagy AM, Abd-Elsayed AA (2009) Single puncture percutaneous nephrolithomy for management of complex renal stones. BMC Res Notes 2:62

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kallidonis P, Kyriazis I, Kotsiris D, Koutava A, Kamal W, Liatsikos E (2017) Papillary vs nonpapillary puncture in percutaneous nephrolithotomy: a prospective randomized trial. J Endourol 31:S4–S9

    Article  PubMed  Google Scholar 

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Funding

This project was supported by grants from the National Natural Science Foundation of China (No. 81970603 and 82100807).

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Author notes

  1. Lujia Wang, Peng Gao, and Zijian Zhou have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Rd, Shanghai, 200040, People’s Republic of China

    Lujia Wang, Peng Gao, Zijian Zhou, Yuanyuan Yang, Qiang Ding & Zhong Wu

  2. Clinical Research Center of Urolithiasis, Shanghai Medical College, Fudan University, Shanghai, 200040, People’s Republic of China

    Lujia Wang, Peng Gao, Zijian Zhou, Yuanyuan Yang, Qiang Ding & Zhong Wu

Authors
  1. Lujia Wang
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  2. Peng Gao
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  3. Zijian Zhou
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  4. Yuanyuan Yang
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  5. Qiang Ding
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  6. Zhong Wu
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Contributions

WZ: Project development, data collection, manuscript writing, and revision; WLJ: data collection, data analysis and manuscript writing; GP: data collection and manuscript editing; ZZJ: data analysis and manuscript editing; YYY: data collection; DQ: data analysis and revision.

Corresponding author

Correspondence to Zhong Wu.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Huashan Institutional Review Board (HIRB) of Fudan University.

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This article does not contain any studies with animals.

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Written informed consent was obtained from each patient.

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Wang, L., Gao, P., Zhou, Z. et al. The optical puncture combined standard percutaneous nephrolithotomy versus the conventional percutaneous nephrolithotomy for kidney stones without hydronephrosis: a comparative study. Int Urol Nephrol 55, 993–1000 (2023). https://doi.org/10.1007/s11255-022-03386-z

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