Mini-nephroscope combined with pressure suction: an effective tool in MPCNL for intrarenal stones in patients with urinary tract infections

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• 作者：Guibin Xu ; Yongzhong He ; Haibo Zhao ; Xianhan Jiang ; Gang Feng ; Weiqing Yang…
• 关键词：Intrarenal calculi ; Percutaneous nephrolithotomy ; Urinary tract infection ; Infection stones
• 刊名：Urological Research
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：44
• 期：5
• 页码：445-450
• 全文大小：620 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Urology and Andrology
  Nephrology
  Medical Biochemistry
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-0879
• 卷排序：44

文摘

We report our experience with a mini-nephroscope connected to pressure suction as a modified minimally invasive percutaneous nephrolithotomy (MPCNL) technique to manage intrarenal stones in patients with a urinary tract infection (UTI). We used a mini-nephroscope connected to pressure suction to aspirate infected urine and reduce intrapelvic pressure. From January 2010 to June 2014, we treated 683 patients with intrarenal stones and UTI with this modified MPCNL technique in our department (Group A). Patients with an intrarenal stone and without UTI treated by this modified MPCNL (Group B, N = 422) and patients with an intrarenal stone and UTI but treated by traditional MCPNL without pressure suction (Group C, N = 95) were collected as control groups. In group A, 635 of the 683 patients (93 %) had a positive urine culture preoperatively and the other 48 patients (7 %) were diagnosed with pyonephrosis intraoperatively. The mean stone bulk was 843 ± 151.4 mm2 and mean operative time was 71.0 ± 11.5 min. The mean stone bulk and operative time were similar to those of group B and group C. However, the rates of infectious complications for groups A (6.4 %) and B (4.9 %) were similar, but higher in group C (28.4 %). In group A, only 38 patients had fever and 6 patients developed sepsis. None of the patients showed progression to multiple organ dysfunction syndrome or died in all of patients. Our results demonstrated that this modified MPCNL technique is safe, feasible, and efficient for managing intrarenal calculi in patients with an UTI.