Effects of single versus multiple tracts on Percutaneous Nephrolithotomy outcomes

Authors

  • Shakir Saleem Balindi College of Medicine, University of Duhok, Duhok, Iraq.
  • Khidhur Saleh Khidhur Duhok Directorate of health, Ministry of Health, Duhok, Iraq.

DOI:

https://doi.org/10.22317/imj.v6i4.1209

Keywords:

Effects, Nephrolithotomy, Percutaneous, Outcomes

Abstract

Objectives: The study designed to compare outcomes and morbidities in patient undergoes multi tracts percutaneous nephrolithotomy (PCNL) versus single tract PCNL.

Methods: From October 2019 to September 2020, 50 patients were prospectively investigated at Azadi Teaching Hospital and Vajeen Private Hospital in Duhok, Iraq. Group A included 25 patients who received single tract PCNL while group B had 25 patients who underwent multiple tract PCNL. Complex renal stones are treated with single or multiple tract PCNL depending on stone configurations and urinary system architecture utilising Guy's stone score. Laboratory and imaging data were correlated with stone size, stone-free rate, mean haemoglobin decrease, operation time, hospital stay, and postoperative problems.

Results: 64% of cases are male and 36% are female. The mean stone size in Group A was 3.3 cm (ranges 2.0 - 4.9 cm), but in Group B it was 5.1 cm (ranges 3.3 - 7.4 cm), which is substantially bigger. Group A's mean operational time was 64.4 minutes (ranges from 30-115 minutes), which is statistically significant compared to multiple tracts' 80.2 minutes (ranges from 45-120minutes). The decline in mean hemoglobin between the two groups is statistically significant. Group A and B had 8% and 12% blood transfusions, which is not significant. Group A had a mean hospital stay of 28.2 hours (20-48 hours), whereas group B had 40.8 hours (ranges 24-96 hours). In group A, 16% of patients experienced post-operative fever, whereas in group B, 20% did. 84% of single tract PCNL and 88% of multiple tract PCNL were stone-free.

Conclusion: Complex renal stones treated by multiple tracts PCNL; is efficient and safe with acceptable postoperative outcomes and complications in comparison to single tract PCNL.

References

Mak, D. K., Smith, Y., Buchholz, N., & El-Husseiny, T. (2016). What is better in percutaneous nephrolithotomy - Prone or supine? A systematic review. Arab journal of urology, 14(2), 101–107. https://doi.org/10.1016/j.aju.2016.01.005

Jeong, C. W., Jung, J. W., Cha, W. H., Lee, B. K., Lee, S., Jeong, S. J., Hong, S. K., Byun, S. S., & Lee, S. E. (2013). Seoul National University Renal Stone Complexity Score for Predicting Stone-Free Rate after Percutaneous Nephrolithotomy. PloS one, 8(6), e65888. https://doi.org/10.1371/journal.pone.0065888

Vicentini, F. C., Marchini, G. S., Mazzucchi, E., Claro, J. F., & Srougi, M. (2014). Utility of the Guy's stone score based on computed tomographic scan findings for predicting percutaneous nephrolithotomy outcomes. Urology, 83(6), 1248–1253. https://doi.org/10.1016/j.urology.2013.12.041

Akhavein, A., Henriksen, C., Syed, J., & Bird, V. G. (2015). Prediction of single procedure success rate using S.T.O.N.E. nephrolithometry surgical classification system with strict criteria for surgical outcome. Urology, 85(1), 69–73. https://doi.org/10.1016/j.urology.2014.09.010

Choi, S. W., Bae, W. J., Ha, U. S., Hong, S. H., Lee, J. Y., Kim, S. W., & Cho, H. J. (2017). Prediction of stone-free status and complication rates after tubeless percutaneous nephrolithotomy: a comparative and retrospective study using three stone-scoring systems and preoperative parameters. World journal of urology, 35(3), 449–457. https://doi.org/10.1007/s00345-016- 1891-6

de la Rosette, J. J., Laguna, M. P., Rassweiler, J. J., & Conort, P. (2008). Training in percutaneous nephrolithotomy--a critical review. European urology, 54(5), 994–1001. https://doi.org/10.1016/j.eururo.2008.03.052

Ingimarsson JP, Dagrosa LM, Hyams ES, Pais Jr VM. External valida-tion of a preoperative renal stone grading system: reproducibility andinter-rater concordance of the Guy’s stone score using preoperativecomputed tomography and rigorous postoperative stone-free criteria.Urology 2014;83:45–9.https://doi.org/10.1016/j.urology.2010.12.026

Noureldin YA, Elkoushy MA, Andonian S. Which is better? Guy's versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol. 2015 Nov;33(11):1821-5.

Kukreja, R., Desai, M., Patel, S., Bapat, S., & Desai, M. (2004). Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. Journal of endourology, 18(8), 715–722. https://doi.org/10.1089/end.2004.18.715

Lai, D., Chen, M., He, Y., Li, X., & Wan, S. (2018). Safety and efficacy of retrograde intrarenal surgery for the treatment of renal stone in solitary kidney patients. Renal failure, 40(1), 390–394. https://doi.org/10.1080/0886022X.2018.1487861.

Rassweiler, J. J., Renner, C., & Eisenberger, F. (2000). The management of complex renal stones. BJU international, 86(8), 919–928. https://doi.org/10.1046/j.1464-410x.2000.00906.x

Yamaguchi, A., Skolarikos, A., Buchholz, N. P., Chomón, G. B., Grasso, M., Saba, P., Nakada, S., de la Rosette, J., & Clinical Research Office Of The Endourological Society Percutaneous Nephrolithotomy Study Group (2011). Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. Journal of endourology, 25(6), 933–939. https://doi.org/10.1089/end.2010.0606

Hegarty, N. J., & Desai, M. M. (2006). Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. Journal of endourology, 20(10), 753–760. https://doi.org/10.1089/end.2006.20.753

Turna, B., Nazli, O., Demiryoguran, S., Mammadov, R., & Cal, C. (2007). Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology, 69(4), 603–607. https://doi.org/10.1016/j.urology.2006.12.021

Brodie KE, Lane VA, Lee TW, Roberts JP, Raghavan A, Hughes D, Godbole PP. Outcomes following 'mini' percutaneous nephrolithotomy for renal calculi in children. A single-centre study. J Pediatr Urol. 2015 Jun;11(3):120.e1-5

Preminger, G. M., Assimos, D. G., Lingeman, J. E., Nakada, S. Y., Pearle, M. S., Wolf, J. S., Jr, & AUA Nephrolithiasis Guideline Panel) (2005). Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. The Journal of urology, 173(6), 1991– 2000. https://doi.org/10.1097/01.ju.0000161171.67806.2a

Ziypak T, Adanur S, Tepeler A, Erdem MR, Akcay M, Armagan A, Ozbey I, Polat O. Endoscopic guided additional access for staghorn calculi. J Endourol. 2014 Oct;28(10):1192-6.

Bryniarski, P., Stelmach, P., Taborowski, P., Rajwa, P., Adamkiewicz, M., Życzkowski, M., & Paradysz, A. (2016). Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience. Medical science monitor : international medical journal of experimental and clinical research, 22, 4918–4923. https://doi.org/10.12659/msm.902163

Hegarty, N. J., & Desai, M. M. (2006). Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. Journal of endourology, 20(10), 753–760. https://doi.org/10.1089/end.2006.20.753

Netto, N. R., Jr, Ikonomidis, J., Ikari, O., & Claro, J. A. (2005). Comparative study of percutaneous access for staghorn calculi. Urology, 65(4), 659–663. https://doi.org/10.1016/j.urology.2004.10.081

Aron, M., Yadav, R., Goel, R., Kolla, S. B., Gautam, G., Hemal, A. K., & Gupta, N. P. (2005). Multi-tract percutaneous nephrolithotomy for large complete staghorn calculi. Urologia internationalis, 75(4), 327–332. https://doi.org/10.1159/000089168

Liu, C., Cui, Z., Zeng, G., Wan, S. P., Li, J., Zhu, W., Zeng, T., & Liu, Y. (2016). The optimal minimally invasive percutaneous nephrolithotomy strategy for the treatment of staghorn stones in a solitary kidney. Urolithiasis, 44(2), 149–154. https://doi.org/10.1007/s00240-015-0803-3

Singla, M., Srivastava, A., Kapoor, R., Gupta, N., Ansari, M. S., Dubey, D., & Kumar, A. (2008). Aggressive approach to staghorn calculi-safety and efficacy of multiple tracts percutaneous nephrolithotomy. Urology, 71(6), 1039–1042. https://doi.org/10.1016/j.urology.2007.11.072

Liang T, Zhao C, Wu G, Tang B, Luo X, Lu S, Dong Y, Yang H. Multi-tract percutaneous nephrolithotomy combined with EMS lithotripsy for bilateral complex renal stones: our experience. BMC Urol. 2017 Feb 28;17(1):15

Thomas, K., Smith, N. C., Hegarty, N., & Glass, J. M. (2011). The Guy's stone score--grading the complexity of percutaneous nephrolithotomy procedures. Urology 78(2), 277–281. https://doi.org/10.1016/j.urology.2010.12.026

Muslumanoglu, A. Y., Tefekli, A., Karadag, M. A., Tok, A., Sari, E., & Berberoglu, Y. (2006). Impact of percutaneous access point number and location on complication and success rates in percutaneous nephrolithotomy. Urologia internationalis, 77(4), 340–346. https://doi.org/10.1159/000096339

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Published

2022-12-26

How to Cite

1.
Saleem Balindi S, Saleh Khidhur K. Effects of single versus multiple tracts on Percutaneous Nephrolithotomy outcomes. Iraq Med J [Internet]. 2022 Dec. 26 [cited 2024 Nov. 23];6(4). Available from: https://iraqmedj.org/index.php/imj/article/view/1209

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