To present our simplified bi-planar fluoroscopic puncture technique, its reduction in the fluoroscopic screening time as well as outcomes and the initial experience for percutaneous nephrolithotomy.
We performed a retrospective review of 136 patients operated with our simplified 0-90° puncture technique for percutaneous nephrolithotomy between 2015 and 2018. All Patients were classified by stone complexity with Guy´s nephrolithometric stone score. The stone-free rate was evaluated by non-enhanced computerized tomography, and residual stones were defined as fragments ≥ 2 mm. Complications were divided according to the Clavien-Dindo classification.
One hundred and thirty-six patients were operated with our puncture technique; 121 patients were performed in supine and 15 in the prone position. Fifty-one were men, and 85 were women with an overall mean age of 44.36 ± 13.23 years. The overall stone-free rate was 62.5%, and 83.8 % after an ancillary procedure. The mean fluoroscopy screening time was 69.47 ± 7.1 and 6 ± 4.1 seconds for the total surgical procedure and the percutaneous puncture, respectively. Complications were present in 25.7%, and no grade IV and V complications were present.
Our first case series with the 0-90° simplified fluoroscopic puncture technique shows a similar stone-free rate and safety profile but a low fluoroscopic screening time compared to the most common previously reported fluoroscopic puncture techniques non-focused on low radiation protocols. Further studies are required to evaluate the reproducibility, external validation, and the learning curve of our simplified 0-90° technique.
Urology. 2020 Mar 14 [Epub ahead of print]
Braulio O Manzo, Francisco Gómez, Alejandro Figueroa, Héctor M Sánchez, Mariana Leal, E Emiliani, Francisco J Sánchez, O Angerri
Hospital Regional de Alta Especialidad del Bajío, Endourology Department. Electronic address: ., Hospital Regional de Alta Especialidad del Bajío, Endourology Department., Autonomous Guadalajara University., Urology Department. Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain., Urología del Centro de Mexico (UROCEM).