Therapeutic and safety evaluation of third-generation super-mini percutaneous nephrolithotomy in treating ≤ 2.5 cm kidney calculi with high CT value_West China Medical Journal

Authors：

 CHEN Bing , HU Zhenxing , LIU Cong , YU Hejiang , WEI Fanjie , YU Rui , ZHOU Wenjie

Department of Urology, the People’s Hospital of Leshan Central District, Leshan, Sichuan 614000, P. R. China;

Corresponding?author：

CHEN Bing, Email: 379037776@qq.com

Keywords：

Super-mini percutaneous nephrolithotomy; Mini percutaneous nephrolithotomy; Kidney calculi; Tubeless

DOI：

10.7507/1002-0179.201904212

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the efficacy and safety of the third-generation super-mini percutaneous nephrolithotomy (SMP) for the treatment of kidney calculi with diameter of ≤2.5 cm and CT value of ≥700 Hu, and discuss the feasibility of adopting the technology in primary hospitals.Methods The clinical data of 64 patients with unilateral kidney calculi (CT value ≥700 Hu, diameter ≤2.5 cm) treated in the People’s Hospital of Leshan Central District between July 2017 and July 2018 were retrospectively analyzed. After random assignment, 30 patients were treated with SMP and 34 were with mini percutaneous nephrolithotomy (MPCNL). The pre-, intra-, and post-operative data were compared and analyzed to evaluate the efficacy and safety.Results The unilateral lesion operations of both groups were successfully completed in the first phase. All patients were given double J tubes after operation, and there were no major complications such as post-operative hemorrhage and sepsis. There was no statistically significant difference in the post-operative hemoglobin decrease, post-operative immediate stone removal rate, post-operative stone removal rate after one month, or the rate of procalcitonin >0.1 μg/L between the two groups (P>0.05). The differences in the lithotripsy time [(29.63±6.28) vs. (25.21±5.19) minutes], post-operative hospital stay [(5.33±0.61) vs. (9.44±0.96) days], rate of indwelling renal fistula (3.3% vs. 50.0%), analgesic demand rate (10.0% vs. 58.8%), and postoperative infectious fever rate (6.7% vs. 26.5%) between SMP group and MPCNL group were statistically significant (P<0.05).Conclusions SMP has the advantages of less trauma, low systemic inflammatory response syndrome incidence, less pain, quick rehabilitation, short hospital stay, tubeless after surgery, etc. It is worthy of extensive promotion in primary hospitals.

Citation： CHEN Bing, HU Zhenxing, LIU Cong, YU Hejiang, WEI Fanjie, YU Rui, ZHOU Wenjie. Therapeutic and safety evaluation of third-generation super-mini percutaneous nephrolithotomy in treating ≤ 2.5 cm kidney calculi with high CT value. West China Medical Journal, 2019, 34(7): 796-800. doi: 10.7507/1002-0179.201904212 Copy

1.	Altunrende F, Tefekli A, Stein RJ, et a1. Clinically insignificant residual fragments after percutaneous nephrolithotomy: medium-term follow-up. J Endourol, 2011, 25(6): 941-945.
2.	中華醫學會重癥醫學分會. 中國嚴重膿毒血癥/膿毒性休克治療指南(2014). 中華內科學雜志, 2015, 54(6): 557-581.
3.	Watterson JD, Soon S, Jana K, et al. Access related complications during percutaneous nephrolithotomy: urology versus radiology at a single academic institution. J Urol, 2006, 176(1): 142-145.
4.	韋巍, 黃劍華, 鐘羽翔, 等. 2~3 cm腎結石的CT值對輸尿管軟鏡碎石效果的預估價值. 中華腔鏡泌尿外科雜志(電子版), 2019, 13(2): 95-98.
5.	Kamal W, Kallidonis P, Kyriazis I, et al. Minituriazed percutaneous nephrolithotomy: what does it mean?. Urolithiasis, 2016, 44(3): 195-201.
6.	郭景陽, 楊文增, 張彥橋, 等. 斜仰臥截石位單通道經皮腎鏡聯合經皮軟鏡治療復雜腎結石的療效觀察. 中國內鏡雜志, 2017, 23(4): 95-97.
7.	Bader MJ, Gratzke C, Seitz M, et al. The " all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol, 2011, 59(6): 1054-1059.
8.	Desai MR, Sharma R, Mishra S, et al. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol, 2011, 186(1): 140-145.
9.	Desai J, Solanki R. Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int, 2013, 112(7): 1046-1049.
10.	Wright A, Rukin N, Smith D, et al. " Mini, ultra, micro” - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques. Ther Adv Urol, 2016, 8(2): 142-146.
11.	Zeng G, Wan S, Zhao Z, et al. Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int, 2016, 117(4): 655-661.
12.	詹鷹, 張宇聰, 王康揚, 等. 超微經皮腎鏡在上尿路結石治療中的臨床應用(附13例報告). 臨床泌尿外科雜志, 2017, 32(2): 141-143.
13.	王亞園, 許長寶, 褚校涵, 等. 超微經皮腎鏡與輸尿管軟鏡治療直徑2-3 cm高CT值腎結石療效對比. 實用醫學雜志, 2018, 34(18): 2181-2183.
14.	Liu Y, AlSmadi J, Zhu W, et al. Comparison of super-mini PCNL (SMP) versus Miniperc for stones larger than 2 cm: a propensity score-matching study. World J Urol, 2018, 36(6): 955-961.
15.	Cai C, Liu Y, Zhong W, et al. The clinical application of new generation super-mini percutaneous nephrolithotomy in the treatment of ≥20 mm renal stones. J Endourol, 2019.
16.	Zeng G, Zhu W, Lam W. Miniaturised percutaneous nephrolithotomy: its role in the treatment of urolithiasis and our experience. Asian J Urol, 2018, 5(4): 295-302.
17.	Tepeler A, Armagan A, Sancaktutar AA, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol, 2013, 27(1): 13-18.
18.	曾國華, 萬肖蓬, 陳文忠, 等. 超微經皮腎鏡取石術治療31例腎結石的初步體會. 中華泌尿外科雜志, 2014, 35(1): 6-9.
19.	Sebaey A, Khalil MM, Soliman T, et al. Standard versus tubeless mini-percutaneous nephrolithotomy: a randomised controlled trial. Arab J Urol, 2016, 14(1): 18-23.

1. Altunrende F, Tefekli A, Stein RJ, et a1. Clinically insignificant residual fragments after percutaneous nephrolithotomy: medium-term follow-up. J Endourol, 2011, 25(6): 941-945.
2. 中華醫學會重癥醫學分會. 中國嚴重膿毒血癥/膿毒性休克治療指南(2014). 中華內科學雜志, 2015, 54(6): 557-581.
3. Watterson JD, Soon S, Jana K, et al. Access related complications during percutaneous nephrolithotomy: urology versus radiology at a single academic institution. J Urol, 2006, 176(1): 142-145.
4. 韋巍, 黃劍華, 鐘羽翔, 等. 2~3 cm腎結石的CT值對輸尿管軟鏡碎石效果的預估價值. 中華腔鏡泌尿外科雜志(電子版), 2019, 13(2): 95-98.
5. Kamal W, Kallidonis P, Kyriazis I, et al. Minituriazed percutaneous nephrolithotomy: what does it mean?. Urolithiasis, 2016, 44(3): 195-201.
6. 郭景陽, 楊文增, 張彥橋, 等. 斜仰臥截石位單通道經皮腎鏡聯合經皮軟鏡治療復雜腎結石的療效觀察. 中國內鏡雜志, 2017, 23(4): 95-97.
7. Bader MJ, Gratzke C, Seitz M, et al. The " all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol, 2011, 59(6): 1054-1059.
8. Desai MR, Sharma R, Mishra S, et al. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol, 2011, 186(1): 140-145.
9. Desai J, Solanki R. Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int, 2013, 112(7): 1046-1049.
10. Wright A, Rukin N, Smith D, et al. " Mini, ultra, micro” - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques. Ther Adv Urol, 2016, 8(2): 142-146.
11. Zeng G, Wan S, Zhao Z, et al. Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int, 2016, 117(4): 655-661.
12. 詹鷹, 張宇聰, 王康揚, 等. 超微經皮腎鏡在上尿路結石治療中的臨床應用(附13例報告). 臨床泌尿外科雜志, 2017, 32(2): 141-143.
13. 王亞園, 許長寶, 褚校涵, 等. 超微經皮腎鏡與輸尿管軟鏡治療直徑2-3 cm高CT值腎結石療效對比. 實用醫學雜志, 2018, 34(18): 2181-2183.
14. Liu Y, AlSmadi J, Zhu W, et al. Comparison of super-mini PCNL (SMP) versus Miniperc for stones larger than 2 cm: a propensity score-matching study. World J Urol, 2018, 36(6): 955-961.
15. Cai C, Liu Y, Zhong W, et al. The clinical application of new generation super-mini percutaneous nephrolithotomy in the treatment of ≥20 mm renal stones. J Endourol, 2019.
16. Zeng G, Zhu W, Lam W. Miniaturised percutaneous nephrolithotomy: its role in the treatment of urolithiasis and our experience. Asian J Urol, 2018, 5(4): 295-302.
17. Tepeler A, Armagan A, Sancaktutar AA, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol, 2013, 27(1): 13-18.
18. 曾國華, 萬肖蓬, 陳文忠, 等. 超微經皮腎鏡取石術治療31例腎結石的初步體會. 中華泌尿外科雜志, 2014, 35(1): 6-9.
19. Sebaey A, Khalil MM, Soliman T, et al. Standard versus tubeless mini-percutaneous nephrolithotomy: a randomised controlled trial. Arab J Urol, 2016, 14(1): 18-23.

West China Medical Journal

Therapeutic and safety evaluation of third-generation super-mini percutaneous nephrolithotomy in treating ≤ 2.5 cm kidney calculi with high CT value

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content