WCE 2019: Percutaneous Nephrolithotomy with Intraoperative CT-guided Evaluation of Stone Free Rate – A Feasibility Study

Abu Dhabi, United Arab Emirates (UroToday.com) Dr. Xiaoye Zhu and his colleagues assessed the capacity of intraoperative CT immediately after PCNL procedure completion as a protocol to more effectively determine whether or not patients were stone free. Dr. Zhu began by noting that fluoroscopy during PCNL may lead to an overestimation of stone-free rate (SFR). SFR is highly dependent on the imaging modality used, and CT gives the clearest picture of stone residuals and fragments. Furthermore, early detection and identification of stones after PCNL will more efficiently target patients into appropriate care.

In his study, Dr. Zhu prospectively evaluated 14 adult patients who underwent PCNL and had subsequent intraoperative CT to evaluate their stone burdens to determine SFR. Six of these 14 patients were found to have residual stone fragments on CT. One patient was kept in the operating suite, where complete removal of his or her fragments was achieved. One patient was rescheduled for ureteroscopy and four patients were scheduled for clinical follow-up after stone fragments could not be fully removed as they were inaccessible via the same tract.

Dr. Zhu had a few parting thoughts on this study. Intraoperative CT during PCNL is a feasible way to accurately assess stone burden in patients and provided a window of opportunity to extract stone fragments. Furthermore, clinical follow-up could be planned and scheduled for these patients immediately.

Presented by: Xiaoye Zhu, MD, PhD, FEBU, Department of Urology, Radboudume University Medical Center, Nijmegen, the Netherlands

Written by: Lillian Xie, BA, Department of Urology, University of California, Irvine, California at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates