Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-8577
Authors: Savko, Olga
Kurosch, Martin
Rothe, Nina
Dotzauer, Robert
Haferkamp, Axel
Mager, Rene
Title: Comparative assessment of multiple-tract vs single-tract percutaneous nephrolithotomy
Online publication date: 17-Jan-2023
Year of first publication: 2022
Language: english
Abstract: Introduction To investigate the efficacy and safety of multi-tract percutaneous nephrolithotomy (PNL) against the benchmark of the single-tract approach. Methods A retrospective analysis of 391 consecutive PNL procedures was conducted in our tertiary referral center between April 2016 and March 2020. Clinical outcome parameters such as stone-free rate, operation time, postoperative complications according to Clavien–Dindo, length of hospital stay and time to ipsilateral recurrence resulting in active treatment were assessed. Results Multi-tract PNL and single-tract PNL were performed in 37 (9%) and 354 (91%) cases respectively. At baseline, compared to single-tract PNL, multi-tract PNL cases were characterized by significantly larger stone burden (2.62 vs 0.97 cm3, P < .00), lower Hounsfield units (HU) (751 vs 1017 HU, P < .01), a more complex S.T.O.N.E. (size, tract length, obstruction, number of calyces, essence) score (P < .00) and a higher rate of high-risk stone formers (59 vs 19%, P < .00). Analysis of outcome revealed shorter operation time and length of hospital stay for single-tract PNL compared to multi-tract PNL (P < .01). However, the difference in terms of stone-free rates (92% vs 88%), complication rates (43% vs 28%) and time to active retreatment due to ipsilateral recurrence was not statistically significant (P > .05). Conclusion In this retrospective single-center analysis, a multi-tract PNL has been proved to be an efficient and safe expansion of single-tract PNL for large stone burden and complex kidney stone disease. Future prospective research should focus on the procedure's potential effectiveness in reducing the number of interventions until stone-free status in patients with massive stone disease.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
ROR: https://ror.org/023b0x485
DOI: http://doi.org/10.25358/openscience-8577
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY-NC-ND
Information on rights of use: https://creativecommons.org/licenses/by-nc-nd/4.0/
Journal: Asian journal of endoscopic surgery
15
4
Pages or article number: 774
780
Publisher: Wiley-Blackwell
Publisher place: Oxford u.a
Issue date: 2022
ISSN: 1758-5910
Publisher DOI: 10.1111/ases.13092
Appears in collections:DFG-491381577-H

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