Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?
Yasser A. Noureldina,b, Mohamed A. Elkoushya,c, Sero Andoniana
a Division of Urology, McGill University Health Centre, Montreal, Québec, Canada; b Department of Urology, Benha University Hospital, Benha University, Benha, Egypt c Department of Urology, Suez Canal University, Ismailia, Egypt
Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?
Yasser A. Noureldina,b, Mohamed A. Elkoushya,c, Sero Andoniana
a Division of Urology, McGill University Health Centre, Montreal, Québec, Canada; b Department of Urology, Benha University Hospital, Benha University, Benha, Egypt c Department of Urology, Suez Canal University, Ismailia, Egypt
摘要 Objective: The aim of this study was to assess whether the presence of a preformed percutaneous renal access (PCA) had any effects on fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL). Methods: After ethics approval was obtained, medical records of all patients who underwent PCNL between 2009 and 2013 at a tertiary stone referral centre were retrospectively reviewed. Patients with and without pre-formed PCA undergoing PCNL were compared. Patients who underwent second-look PCNL and those who had their access inserted by interventional radiology constituted the group with pre-formed PCA. Results: A total of 185 PCNLs were reviewed. The mean patient age was 55.2± 1.0 years with mean body mass index (BMI) of 27.8± 0.5 kg/m2 and male gender of 63.8%. The mean stone size was 618.4± 47.0 mm2 with mean Guy's grade of 2.3± 0.7 and mean S.T.O.N.E. score of 7.6± 0.1. The mean operative time was 98.7± 2.6 min with mean FT of 113.4± 4.5 s. The overall stone-free rate was 71.9% with complication rate of 16.2%. When compared with PCNLs without pre-formed PCA, PCNLs with pre-formed PCA were associated with significantly shorter FT (120.6± 5.1 vs. 77.5± 6.7 s; p < 0.001) and significantly lower estimated blood loss (EBL) (p = 0.01). On multivariate analysis, PCNLs with pre-formed PCA were associated with significantly shorter FT (B. coefficient =±43.2 (95%CI:±66.4 to±20); p < 0.001) and lower EBL (p = 0.02).
Abstract: Objective: The aim of this study was to assess whether the presence of a preformed percutaneous renal access (PCA) had any effects on fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL). Methods: After ethics approval was obtained, medical records of all patients who underwent PCNL between 2009 and 2013 at a tertiary stone referral centre were retrospectively reviewed. Patients with and without pre-formed PCA undergoing PCNL were compared. Patients who underwent second-look PCNL and those who had their access inserted by interventional radiology constituted the group with pre-formed PCA. Results: A total of 185 PCNLs were reviewed. The mean patient age was 55.2± 1.0 years with mean body mass index (BMI) of 27.8± 0.5 kg/m2 and male gender of 63.8%. The mean stone size was 618.4± 47.0 mm2 with mean Guy's grade of 2.3± 0.7 and mean S.T.O.N.E. score of 7.6± 0.1. The mean operative time was 98.7± 2.6 min with mean FT of 113.4± 4.5 s. The overall stone-free rate was 71.9% with complication rate of 16.2%. When compared with PCNLs without pre-formed PCA, PCNLs with pre-formed PCA were associated with significantly shorter FT (120.6± 5.1 vs. 77.5± 6.7 s; p < 0.001) and significantly lower estimated blood loss (EBL) (p = 0.01). On multivariate analysis, PCNLs with pre-formed PCA were associated with significantly shorter FT (B. coefficient =±43.2 (95%CI:±66.4 to±20); p < 0.001) and lower EBL (p = 0.02).
Yasser A. Noureldin, Mohamed A. Elkoushy, Sero Andonian. Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?[J]. Asian Journal of Urology, 2015, 2(4): 220-223.
Yasser A. Noureldin, Mohamed A. Elkoushy, Sero Andonian. Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?. Asian Journal of Urology, 2015, 2(4): 220-223.
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