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Necole M Streeper
PURPOSE OF REVIEW: There are no current guidelines on the optimal management of asymptomatic renal stones. This review summarizes the current literature, focusing on more recent studies that have been done to grow the body of evidence on this topic. RECENT FINDINGS: Recent studies have found that stone size is a significant predictor of need for future surgical intervention, with > 7 mm for pediatric population and > 4 mm for residual fragments after both PNL and ureteroscopy (URS)...
March 17, 2018: Current Urology Reports
Mohammed S ElSheemy, Akram A Elmarakbi, Mohammed Hytham, Hamdy Ibrahim, Sanjay Khadgi, Ahmed M Al-Kandari
To compare the outcome of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for renal stones. Retrospective study was performed between March 2010 and May 2013 for patients treated by Mini-PNL or standard-PNL through 18 and 30 Fr tracts, respectively, using pneumatic lithotripsy. Semirigid ureteroscope (8.5/11.5 Fr) was used for Mini-PNL and 24 Fr nephroscope for standard-PNL. Both groups were compared in stone free rate(SFR), complications and operative time using Student-t, Mann-Whitney, Chi square or Fisher's exact tests as appropriate in addition to logistic regression analysis...
March 16, 2018: Urolithiasis
Engin Kaya, Turgay Ebiloğlu, Murat Zor, Serdar Yalçın, Adem Emrah Coğuplugil, Selahattin Bedir
Objective: To determine the success rate of percutaneous nephrolithotomy (PNL) in kidney stones over 50 milimeters. Material and methods: Twenty-four patients with a renal stone size of >50 mm between January 2007 and December 2016 were enrolled. Stone-free and complication rates were investigated. Results: Twenty-one (87.5%) patients were male and 3 (12.5%) were female. Fifteen (62.5%) stones were located in the right, and 9 (37.5%) in the left kidney...
March 2018: Turkish Journal of Urology
Hikmat Jabrayilov, Murat Yavuz Koparal, Serhat Gürocak, Bora Küpeli, Mustafa Özgür Tan
In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm...
March 4, 2018: Journal of Clinical Medicine
Joel E Abbott, Julio G Davalos
Background: Percutaneous nephrolithotomy (PNL) is a procedure that has traditionally been performed in an inpatient or hospital setting. Many surgical procedures have evolved over time from an inpatient/hospital setting to outpatient procedures performed in surgical centers. Outpatient PNL has become an accepted standard in select patients, but to date, the procedure has not been performed in an outpatient surgical center. Case Presentation: We describe our initial experience managing large renal stone burden with PNL performed completely outpatient in a freestanding ambulatory surgery center...
2018: Journal of Endourology Case Reports
Kelly Spuur, Jodi Webb, Ann Poulos, Sharon Nielsen, Wayne Robinson
AIM: The aim of this study is to determine the clinical rates of the demonstration of the inframammary angle (IMA) on the mediolateral oblique (MLO) view of the breast on digital mammograms and to compare the outcomes with current accreditation standards for compliance. Relationships between the IMA, age, the posterior nipple line (PNL) and compressed breast thickness will be identified and the study outcomes validated using appropriate analyses of inter-reader and inter-rater reliability and variability...
March 2018: European Journal of Radiology
Haijin Fu, Guolong Wu, Pengcheng Hu, Ruidong Ji, Jiubin Tan, Xuemei Ding
Heterodyne interferometers suffer from thermal drift of optics (TDO), which may introduce error even up to several micrometers. In this paper, we propose a symmetric heterodyne interferometer with spatially separated beams, which realizes completely balanced optical paths between probe and reference beams and simultaneously avoids the optical mixing, and thereby is theoretically capable of eliminating TDO and the periodic nonlinearity (PNL). To validate the performance of the proposed interferometer, first a special experimental setup is constructed, with which the TDO test can be conducted in vacuum, and the result shows that a thermal coefficient of 1...
February 20, 2018: Applied Optics
Amihay Nevo, Ronen Holland, Eran Schreter, Ron Gilad, Jack Baniel, Aenov Cohen, David Lifshitz
OBJECTIVES: To determine the accuracy of the surgeon's impression as to the stone free rate at the end of percutaneous nephrolithotomy (PNL), and to evaluate predictors for inaccurate estimation. MATERIALS AND METHODS: A prospective study conducted between 2010 and 2015. Surgeon's impression, categorized as "insignificant Residual fragments (RF)" (<4 mm) or "significant RF" (> 4mm), was recorder at the end of PNL, and was compared with postoperative imaging results, using CT or a combination of US and KUB for radiolucent and radio-opaque stones, respectively...
February 21, 2018: Journal of Endourology
Chang-Liang Yao, Hui-Qin Pan, Hui Wang, Shuai Yao, Wen-Zhi Yang, Jin-Jun Hou, Qing-Hao Jin, Wan-Ying Wu, De-An Guo
Liquid chromatography-mass spectrometry (LC-MS) guided isolation is a favored strategy to quickly and efficiently explore the chemical diversity of herbal medicines. In this study, two methods were adopted to improve the performance of the strategy, including offline two-dimensional (2D) LC to extend the peak capacities and predicted metabolites screening (PMS) to automatically screen the targets with expanded databases. Ginsenosides in the leaves of Panax notoginseng (PNL) were taken as a case. An offline 2D LC system was constructed with an orthogonality of 0...
January 26, 2018: Journal of Chromatography. A
L D Arustamov, M I Katibov, D S Merinov, Sh Sh Gurbanov, A V Artemov, V A Epishov
RELEVANCE: Management of patients with large and staghorn stones of a solitary kidney is widely debated among urologists and has not been sufficiently investigated, which determined the relevance of this study. MATERIALS AND METHODS: The study comprised 80 patients with large (>20 mm) and staghorn stones of an anatomically or functionally solitary kidney. Of them, 58 patients underwent percutaneous nephrolithotripsy (PNL), and 22 had open surgery. The criterion of the treatment effectiveness was the complete stone clearance or small residual fragments sized less than 3 mm...
December 2017: Urologii︠a︡
Simon Hein, Dominik Stefan Schoeb, Ingo Grunwald, Katharina Richter, Jörg Haberstroh, Maximilian Seidl, Peter Bronsert, Ulrich Wetterauer, Martin Schoenthaler, Arkadiusz Miernik
PURPOSE: To evaluate the viability and biocompatibility of a novel, patented bioadhesive system for intrarenal embedding and retrieval of residual fragments after endoscopic lithotripsy. Complete stone clearance via active removal of residual fragments (RF) after intracorporeal laser lithotripsy may be time-consuming and fail in many cases. Therefore, the novel adhesive has been developed and evaluated for the first time in an in vivo pig model in the present work. METHODS: Four female domestic pigs underwent flexible ureteroscopy (RIRS) or percutaneous nephrolithotomy (PNL) under general anesthesia (8 kidneys, 4 × RIRS, 4 × PNL) evaluating the bioadhesive system...
January 24, 2018: World Journal of Urology
Necdet Poyraz, Mehmet Balasar, İbrahim Erdem Gökmen, Osman Koç, Mehmet Giray Sönmez, Arif Aydın, Yunus Emre Göger, Ahmet Öztürk
Introduction: Percutaneous nephrolithotomy (PNL) is the preferred procedure for safe and effective surgical treatment of kidney stones. Hemorrhage is the most serious complication of PNL, resulting from pseudoaneurysm (PA) or arteriovenous fistula (AVF), and can usually be controlled with conservative treatment. Aim: To evaluate endovascular treatments and outcomes of vascular complications observed after PNL. Material and methods: We retrospectively reviewed data on 19 patients who underwent renal embolization due to post-PNL renal artery bleeding between March 2005 and September 2016...
December 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
C Fernández-Baltar, D Pérez-Fentes, J F Sánchez-García, C García-Freire
In developed countries, the incidence of cardiovascular disease is increasing, therefore, anticoagulant and antiplatelet drugs are a widespread treatment nowadays. Percutaneous nephrolithotomy (PNL) is the first-line treatment for large or complex stones (> 2 cm) and remains an alternative for the smaller ones. The objective of this study is to analyze whether PNL surgery is a safe procedure in patients under a treatment discontinuation protocol for anticoagulant or antiplatelet therapies. We retrospectively studied 301 patients who underwent PNL in our hospital between 2008 and 2016 and identified 46 patients on chronic antiplatelet or anticoagulation treatment...
January 22, 2018: Urolithiasis
Ismail Karlidag, Deniz Abat, Adem Altunkol, Volkan Izol, Erkan Demir, Ibrahim Atilla Aridogan
PURPOSE: The purpose of this study is to evaluate the preoperative, early and late postoperative homocysteine levels and its relationship with kidney function in patients after undergoing percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: Twenty-three patients with kidney stones underwent PNL and blood samples were taken preoperatively as well as at 48 hours and three months after the operation. The homocysteine level was determined by high pressure liquid chromatography and the fluorometric method in blood samples with ethylenediaminetetraaceticacid...
January 4, 2018: Urology Journal
Deng Li, Ming-Lei Sha, Lei Chen, Ying-Long Xiao, Jian Zhuo, Jun Lu, Yi Shao
OBJECTIVE: To evaluate the risk factors for postoperative fever and to identify the value of preoperative procalcitonin (PCT) in predicting postoperative fever after percutaneous nephrolithotomy (PNL). PATIENTS AND METHODS: Patients who underwent PNL between January 2014 and March 2017 were studied. In total, 363 medical records with complete data were determined to be eligible for analysis. Patients were classified into a control or febrile group according to the presence of a body temperature over 38°C...
January 12, 2018: Journal of Endourology
Martin Schoenthaler, Simon Hein, Christian Seitz, Christian Türk, Hansjörg Danuser, Werner Vach, Arkadiusz Miernik
OBJECTIVE: To elucidate the current treatment strategies of LRS in German-speaking Europe. Little is known about the treatment of large renal stones (LRS > 3 cm) in daily urological practice. LRS therapy can be, however, challenging and hazardous. MATERIALS AND METHODS: A 39 item web-based survey was performed among urologists listed by the German, Austrian and Swiss Associations of Urology, addressing professionals treating LRS "on their own" and working in a German-speaking country...
March 2018: World Journal of Urology
Peter Alken
Since the introduction of ESWL, PNL and URS during the early 1980s the application rate of ESWL has declined while those of PNL and URS have increased. This is mainly due to the facts that instruments and techniques for Intracorporeal Lithotripsy (IL) have made a continuous progress. This review shows that today an array of options for IL within the entire urinary tract is available to treat stones in a perfect minimal invasive way. At the same time further improvements of IL are already visible.
February 2018: Urolithiasis
Cesare Marco Scoffone, Cecilia Maria Cracco
Modern-day percutaneous nephrolithotomy (PNL) has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrumentation technology, lithotripsy devices and drainage management. The introduction of the supine and supine-modified positions is also part of this evolution, enabling comfortable and safe procedures from an anaesthesiological point of view, and an easy combined retrograde surgery [Endoscopic Combined IntraRenal Surgery (ECIRS)], allowing tailoring of the procedure on the patient, the dynamic anatomy of the collecting system and the urolithiasis...
February 2018: Urolithiasis
Diogo Fernandes Dos Santos, Matheus Rocha Mendonça, Douglas Eulálio Antunes, Elaine Fávaro Pípi Sabino, Raquel Campos Pereira, Luiz Ricardo Goulart, Isabela Maria Bernardes Goulart
BACKGROUND: Leprosy neuropathy is considered the most common peripheral neuropathy of infectious etiology worldwide, representing a public health problem. Clinical diagnosis of primary neural leprosy (PNL) is challenging, since no skin lesions are found and the slit skin smear bacilloscopy is negative. However, there are still controversial concepts regarding the primary-neural versus pure-neural leprosy definition, which will be explored by using multiple clinical-laboratory analyses in this study...
November 2017: PLoS Neglected Tropical Diseases
Alberto Breda, Angelo Territo, Cesare Scoffone, Christian Seitz, Thomas Knoll, Thomas Herrmann, Mariannhe Brehmer, Palle J S Osther, Evangelos Liatsikos
INTRODUCTION: Percutaneous nephrolithotomy (PNL) is the treatment of choice for larger and complex renal calculi. First step in performing PNL is to obtain access to the renal cavity using either fluoroscopy or ultrasound (US) guidance or a combination of both. Which guiding method to choose is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous nephrolithotomy"...
November 12, 2017: Scandinavian Journal of Urology
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