Category: Clinical Stones: PCNL

MP12-4 - Outcome of Mini percutaneous nephrolithotomy for renal and upper ureteric stone up to 3 cm by Pneumatic lithotripsy / clinical stone PCNL

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : Percutaneous nephrolithotomy (PCNL)is the  standard  treatment of complex and large renal stone. During the past 20 years ,the instruments used have been miniaturized to decrease morbidity associated with standard PCNL.  Today the term MiniPCNL or MiniPERC usually describe the tract size between 14-22 FR, Although the clear definition does not exist. In this study we want to evaluate the efficacy and safety of MiniPCNL to treat kidney and upper ureteric stone upto 3cm by Pneumatic lithotripsy.

Methods :

From November 2013 to December 2017 , the medical records of 213 patients who underwent  MiniPCNL for renal and upper ureteric stone were reviewed retrospectively. The procedure were performed by single surgeon in different private  hospital like Japan Bangladesh friendship hospital Dhaka; Lab aid hospital, Dhaka; Shomorita hospital , Dhaka ; Reliance kidney Hospital , Dhaka . All patients were evaluated by Plain X-ray kidney, Ureter and bladder region(KUB), Ultrasound of KUB region, intravenous urogram and or noncontrast computerized tomography. All pre, intra  and post operative data were analysed.

Results :

A total of  213 patients (Male 165,female 48) with  age 12-65 years were included in this study . the size of the stone was 1-3 cm and laterality of the stone were 170 right and 43 left. A 12 Fr Karl-storz nephroscope with pneumatic intracorporeal lithotripsy were used through 16.5 Fr and 21Fr metallic access sheath. The operative time was 40 - 90 minutes , 165 patients did not need any blood transfusion, 85 ended in totally tubeless and 42 JJ stentless procedure and hospital stay were 2-4 days. Stone free rate was 96%. No major complication classified as clavien grading  observed in this study group. 9 patients underwent auxiliary procedures, of which 3 ureteroscopy and intracorporeal pneumatic lithotripsy , 2 redo miniPCNL, 4 extracorporeal shockwave lithotripsy.

Conclusions :

MiniPCNL with pneumatic lithotripsy can be performed effectively and safely to manage kidney and upper ureteric stone upto 3 cm with high stone free rate and minimum morbidity.

Tohid MD SAIFUL. Hossain

Associate professor urology
Bangabandhu Sheikh mujib medical university, shahabag, Dhaka
Dhaka, Dhaka, Bangladesh

Tahmina Karim

Assistant professor
Bangabandhu Sheikh mujib medical university, shahabag, Dhaka
Dhaka, Dhaka, Bangladesh

Abm Alam

Professor of anesthesiology
shahid suharawardi medical college , sher e bangla nagar
Dhaka, Dhaka, Bangladesh

Mubin Hasanat

chief medical officer of surgery
Japan bagladesh friendship hospital
Dahka, Dhaka, Bangladesh