Mp29-03 Compare Safety and Efficacy of Multiple-Tract vs Single-Tract Percutaneous Nephrolithotomy, a Single-Center Experience

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) III (MP29)1 May 2024MP29-03 COMPARE SAFETY AND EFFICACY OF MULTIPLE-TRACT VS SINGLE-TRACT PERCUTANEOUS NEPHROLITHOTOMY, A SINGLE-CENTER EXPERIENCE Kamran Hassan Bhatti Kamran Hassan BhattiKamran Hassan Bhatti View All Author Informationhttps://doi.org/10.1097/01.JU.0001008680.67760.37.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal stones are one of the most common urinary tract disorders.1 Management of such stones depends on many factors like stone size, site, complexity, and patient factors.2 In complex renal stones, PCNL is a safe and efficient tool in the armamentarium of renal stone management with a relatively low incidence of significant complications. Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large complex renal stones and staghorn calculi.4 In complex and staghorn stones with multiple calyceal involvement, access to all the calyces is difficult through one percutaneous tract, in which case multiple-access PCNL is the mainstay of treatment to achieve better stone clearance and reduce the need for secondary ESWL. However, multiple-tract procedures have been associated with increased bleeding and transfusion rates.5 In this study, the primary endpoint was to evaluate the effectiveness of multiple puncture PCNL in complex renal stones. The secondary endpoint was to investigate the safety and complication rate of this approach. METHODS: A retrospective analysis of 500 consecutive PCNL procedures was conducted in our tertiary referral center between JAN 2014 and DEC 2022.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 PCNL and single-tract PCNL were performed in 50 (10 %) and 450 (90%) cases respectively. At baseline, compared to single-tract PNL, multi-tract PCNL cases were characterized by significantly larger stone burden (2.48 vs 0.92 cm3, p.05). CONCLUSIONS: In this retrospective single-center analysis, a multi-tract PCNL has been proved to be an efficient and safe expansion of single-tract PCNL 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. KEYWORDS multiple-tract, percutaneous nephrolithotomy, staghorn calculi. Source of Funding: NIL © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e481 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kamran Hassan Bhatti More articles by this author Expand All Advertisement PDF downloadLoading ...