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 |
Files in This Item:
File | Description | Size | Format | ||
---|---|---|---|---|---|
comparative_assessment_of_mul-20230117102221785.pdf | 605.95 kB | Adobe PDF | View/Open |