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Beitragstitel Super-mini percutaneous nephrolithotomy: is this the future of PCNL?
Beitragscode P032
Autor:innen
  1. Fabian Schoofs Präsentierende:r
  2. Giuseppe Celentano University College London
  3. Hamid Abboudi University College London
  4. Syed Bilal University College London
  5. Clare Allen University College London
  6. Simon Choong University College London
Präsentationsform Freie Mitteilungen
Themengebiete
  • Niere
Abstract-Text Introduction
Super-mini PCNL (SMP) is a novel method that differs from other miniaturisation techniques by offering continue low - pressure suction and controlled high pressure suction through the unique 14Fr disposable sheath (ClearPetra) while laser lithotripsy is performed. The ClearPetra sheath allows the use of rigid and flexible nephroscopy to treat kidney stones. The objective of this study was to assess safety and surgical outcomes.

Methods
Patients with renal stones not suitable for ESWL or retrograde intrarenal surgery (RIRS) and those with stones requiring a PCNL underwent SMP and data was collected retrospectively.
Only patients who had completed a minimum of 3 months follow up were included.
Stone parameters (size, Hounsfield unit and complexity according to Guy’s stone score) were evaluated before the procedure. Peri-operative outcomes (operative time, Haemoglobin drop, transfusion rate), complications, length of stay and stone-free status were evaluated.
Ultrasound or CT-scan was performed 6-8 weeks post-operatively to determine stone-free status. Stone-free status was defined as no residual fragments of any size.

Results
A total of 46 patients underwent SMP between January 2016 and December 2018.
76% of patients (35/46) were totally tubeless. 24% of patients (11/46) had tubes sited; Eight had nephrostomy tubes, mainly for mild bleeding from the tract; two had antegrade stents inserted and one a ureteric catheter for overnight drainage. 61 percent of patients (28/46) had less than 24 hours admission and the mean hospital stay was 2.5 days. The mean Hb drop was 14g/L and no patients required a blood transfusion. One patient (2.2%) required an embolization for a arteriovenous fistula. Stone free rate at 3 months was 82.6 % (38/46).

Conclusion
Our results of SMP demonstrate that this technique is safe and effective in the treatment of stones smaller than 20mm. It is associated with a low level of blood loss, short operative times, minimal need for drainage tubes and short length of stay.