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2016 ; 32
(2
): 132-6
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Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for
percutaneous stone removal
#MMPMID27127356
Agrawal MS
; Agarwal K
; Jindal T
; Sharma M
Indian J Urol
2016[Apr]; 32
(2
): 132-6
PMID27127356
show ga
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) has witnessed rapid
advancements, the latest being ultra-mini-percutaneous nephrolithotomy (UMP),
which makes the use of 11-13F sheaths as compared to 24-30F sizes used in
conventional PCNL. This miniaturization aims to reduce morbidity and improve
patient outcomes. We evaluated the safety and efficacy of UMP and report our
ourtcomes. PATIENTS AND METHODS: A total of 120 patients underwent UMP from July
2012 to March 2014. These patients had a single unilateral renal stone measuring
between 8 and 20 mm. All patients underwent UMP using a 3F nephroscope, 7.5F
inner sheath, and 11F or 13F outer metallic cannula, which served as the Amplatz
sheath. Stone fragmentation and clearance were achieved with holmium laser. No
nephrostomy or stent was used routinely. RESULTS: Complete stone fragmentation
was achieved in 114 out of 120 patients (95%) using UMP; whereas the remaining 6
were converted into mini-PCNL using a 12.5F nephroscope and 15F Amplatz sheath.
The mean operative time was 39.7 ± 15.4 min, and the mean postoperative hospital
stay was 22.3 ± 2.2 h. Postoperatively, 6 (5%) patients had residual fragments
measuring ?4 mm. At the 2 weeks follow-up, the stone-free status was >99%
(119/120). There were no significant postoperative complications. CONCLUSION:
This study shows UMP to be an effective and safe procedure for managing stones up
to 20 mm. This procedure offers an attractive alternative to shock wave
lithotripsy and retrograde intrarenal surgery for managing small stones.