Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi
Complex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved. Percutaneous nephrolithotomy (PCNL) remains the treatment modality of choice in dealing with these large and complex stones. The limiting factor in their treatment continues t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219301419 |
| _version_ | 1811335679020367872 |
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| author | Sudharsan Balaji Arvind Ganpule Thomas Herrmann Ravindra Sabnis Mahesh Desai |
| author_facet | Sudharsan Balaji Arvind Ganpule Thomas Herrmann Ravindra Sabnis Mahesh Desai |
| author_sort | Sudharsan Balaji |
| collection | DOAJ |
| description | Complex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved. Percutaneous nephrolithotomy (PCNL) remains the treatment modality of choice in dealing with these large and complex stones. The limiting factor in their treatment continues to be the need for using additional tracts or the use of flexible nephroscopy for complete stone clearance. This systematic review focuses on the need for multi-tract PCNL for complex renal calculi. The literature review was performed using PubMed database using the keywords “multiple tract PCNL” or “multiperc”. We identified original articles published on the usage of multiple tracts for stone clearance in renal calculi between January 2000 to October 2018, and the search was restricted to available literature in English language only. Ten studies with n>20 were included for the final analysis. We analyzed the technical efficacy with respect to the number of tracts and stages that were required for stone clearance, outcomes and complications, especially, procedural bleeding and post-procedure infective complications of multiple-tract PCNL for large burden renal stones. Multiperc is found to be safe, feasible and effective for the management of large burden complex renal calculi with respect to stone clearance and morbidity associated with the procedure. It is cost effective and complete stone clearance as a single procedure is higher in comparison to flexible ureteroscopy and shockwave lithotripsy. Keywords: Percutaneous nephrolithotomy, Multiple tract, Multiperc, Complex renal calculi, Surgical management |
| first_indexed | 2024-04-13T17:27:50Z |
| format | Article |
| id | doaj.art-660ac78087464c58bb2493f36aa7799e |
| institution | Directory Open Access Journal |
| issn | 2214-3882 |
| language | English |
| last_indexed | 2024-04-13T17:27:50Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj.art-660ac78087464c58bb2493f36aa7799e2022-12-22T02:37:42ZengElsevierAsian Journal of Urology2214-38822020-04-0172102109Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculiSudharsan Balaji0Arvind Ganpule1Thomas Herrmann2Ravindra Sabnis3Mahesh Desai4Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, IndiaDepartment of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India; Corresponding author.Department of Urology, Spital Thurgau AG STGAG Kantonspital Frauenfeld and Kantonspital Münsterlingen, Thurgau, SwitzerlandDepartment of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, IndiaDepartment of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, IndiaComplex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved. Percutaneous nephrolithotomy (PCNL) remains the treatment modality of choice in dealing with these large and complex stones. The limiting factor in their treatment continues to be the need for using additional tracts or the use of flexible nephroscopy for complete stone clearance. This systematic review focuses on the need for multi-tract PCNL for complex renal calculi. The literature review was performed using PubMed database using the keywords “multiple tract PCNL” or “multiperc”. We identified original articles published on the usage of multiple tracts for stone clearance in renal calculi between January 2000 to October 2018, and the search was restricted to available literature in English language only. Ten studies with n>20 were included for the final analysis. We analyzed the technical efficacy with respect to the number of tracts and stages that were required for stone clearance, outcomes and complications, especially, procedural bleeding and post-procedure infective complications of multiple-tract PCNL for large burden renal stones. Multiperc is found to be safe, feasible and effective for the management of large burden complex renal calculi with respect to stone clearance and morbidity associated with the procedure. It is cost effective and complete stone clearance as a single procedure is higher in comparison to flexible ureteroscopy and shockwave lithotripsy. Keywords: Percutaneous nephrolithotomy, Multiple tract, Multiperc, Complex renal calculi, Surgical managementhttp://www.sciencedirect.com/science/article/pii/S2214388219301419 |
| spellingShingle | Sudharsan Balaji Arvind Ganpule Thomas Herrmann Ravindra Sabnis Mahesh Desai Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi Asian Journal of Urology |
| title | Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| title_full | Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| title_fullStr | Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| title_full_unstemmed | Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| title_short | Contemporary role of multi-tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| title_sort | contemporary role of multi tract percutaneous nephrolithotomy in the treatment of complex renal calculi |
| url | http://www.sciencedirect.com/science/article/pii/S2214388219301419 |
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