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ABSTRACT: PURPOSE: To investigate the feasibility of the all-seeing needle for safe entry and creation of pneumoperitoneum in pediatric urological laparoscopy. MATERIALS AND METHODS: A total of 14 children underwent various transperitoneal urological laparoscopic procedures. The all-seeing needle which is 4.85 Fr diameter were used for safe entry into the abdominal cavity at the site of the umblicus in all cases. The micro-optic was integrated with the light system and connected via a zoom ocular enabling direct visualization of the layers between the skin and the peritoneal cavity. Once the intra-peritoneal access was obtained, CO2 pneumoperitoneum was created from one port of the three-way connector attached to the proximal part of the needle. Then the laparoscopic trocars were placed under vision of the micro-optical system. RESULTS: Mean age of the children was 4.5±2.9 years. In all children, the all-seeing needle was safely introduced into the abdominal cavity under direct vision. Then, CO2 pneumoperitoneum was succesfully performed. The mean time for optical puncture was calculated as 1.1±0.8 min. No complication was encountered during the introduction of the needle, creation of the pneumoperitoneum and placement of the trocars. CONCLUSIONS: The all-seeing needle appears to be beneficial in safe entry and for creating pneumoperitoneum in laparoscopic pediatric urology cases. It eliminates the disadvantages of the Veress needle which is blunt insertion and may possibly prevents from complications.
Journal of endourology / Endourological Society 04/2013; · 1.75 Impact Factor
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ABSTRACT: Background and Purpose: To compare the advantages of flexible and rigid cystoscopy assisted ureteral catheter placement prior to prone percutaneous nephrolithotomy (PNL). Patients and Methods: From March to September 2012, a total of 80 patients with kidney stone underwent PNL by the same surgical team. The patients were randomly assigned into one of the groups according to the technique used for ureteral catheter insertion: flexible cystoscopy (Group-1, n: 40) or rigid cystoscopy (Group-2, n: 40). Patients' demographics and operation related factors were compared. Preparation period included positioning, cystoscopy assisted-stent insertion and patient re-positioning for PNL. Additionally, discomfort scores of the operating room (OR) staff were measured. Results: The demographic values of the groups in terms of patient sex, age, BMI and stone size were comparable. While the mean preparation period was calculated as 9.9 ± 2.3 minutes in flexible cystoscopy group, it was significantly longer (19.7 ± 2.9 minutes) in rigid cystoscopy group (p<0.0001). Additionally, the discomfort score of the OR staff was found to be significantly higher in rigid cystoscopy group (1.1 ± 0.9 vs. 2.05 ± 0.68, p<0.0001). The rest of the operative and postoperative parameters were similar. Conclusions: The insertion of ureteral catheter with flexible cystoscope prior to prone PNL shortens the preparation period and minimizes the discomfort of OR staff related to patient positioning and transfer.
Journal of endourology / Endourological Society 02/2013; · 1.75 Impact Factor
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Abdulkadir Tepeler,
Murat Binbay, Tolga Akman,
Akif Erbin,
Cem Kezer,
Mesrur Selcuk Silay,
Emrah Yuruk,
Sina Kardas,
Muzaffer Akçay,
Abdullah Armagan,
Ahmet Yaser Muslumanoglu
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ABSTRACT: Objective: To evaluate whether renal parenchymal thickness (RPT) has an effect on the outcomes of percutaneous nephrolithotomy (PNL). Methods: We performed a retrospective analysis of 144 patients with lower pole and/or renal pelvic stones who underwent PNL. The relationship between RPT and peri- and postoperative measures was evaluated. Results: The average age was 45.94 ± 14.47 (15-76) years. The mean BMI was calculated as 27.47 ± 4.73 (16.9-44.9) kg/m(2). The mean stone burden was 293 ± 126 (150-800 mm(2)). The mean RPT was measured as 17.33 ± 5.32 (6-35) mm. No correlation was detected between the RPT and the operation or fluoroscopy times or the duration of hospitalization (p = 0.63, 0.52, 0.08, respectively). The mean drop in hemoglobin level was 1.45 ± 1.25 (0-9) g/dl. A negative correlation was detected between hemoglobin drop and RPT (p = 0.01, r = -0.23). However, the RPT was similar in patients who did or did not require a blood transfusion (p = 0.09). The RPT was found to have no impact on success rate (p = 0.4). Conclusion: The postoperative hemoglobin drop increases in parallel with the increase in RPT. However, no relationship was detected between the RPT and blood transfusion, overall success rate or any other perioperative parameters.
Urologia Internationalis 01/2013; · 0.99 Impact Factor
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ABSTRACT: Objectives: It was the aim of this study to evaluate and compare the outcomes of percutaneous nephrolithotomy (PNL) for the treatment of posterior and anterior caliceal stones. Patients and Methods: We performed a retrospective analysis of 86 patients with isolated caliceal stones who underwent PNL between 2011 and 2012. The patients were classified into two groups according to the localization of the stone, either in the anterior (group 1, n = 41) or posterior (group 2, n = 45) calyx, on axial plane computed tomography. Results: The mean age, male/female ratio and stone size and location were similar in both groups. Fluoroscopy, operation time and duration of hospitalization were also similar between groups. Patients in group 1 had a greater postoperative hemoglobin drop than patients in group 2. Blood transfusion was required for 5 patients in group 1 and for 4 patients in group 2. In addition, open conversion was required for 2 patients in group 1 during the early postoperative period because of extensive bleeding. Hemodynamics were stabilized with angioembolization in 2 patients with prolonged hematuria in group 1. The overall success and complication rates were similar in both groups. Conclusion: Although the postoperative hemoglobin drop did not significantly differ between groups, hemorrhaging was more severe in patients with anterior caliceal stones than in those with posterior caliceal stones.
Urologia Internationalis 01/2013; · 0.99 Impact Factor
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ABSTRACT: Abstract Treatment of kidney stones in pelvic ectopic kidneys of children is a challenging procedure for urologists. Herein we report a case of laparoscopy-assisted "microperc" in a 3-year-old girl with a stone in her pelvic ectopic kidney. This micro-optical system is helpful in confirming the percutaneous access and provides the possibility of fragmenting the stone without the necessity of dilating the tract.
Journal of Laparoendoscopic & Advanced Surgical Techniques 11/2012; · 1.40 Impact Factor
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ABSTRACT: Study Type - Prognosis (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The presence of metabolic syndrome is associated with development of kidney stones and an increase in the stone-recurrence rate. However, studies reporting long-term results of percutaneous nephrolithotomy (PCNL) in metabolic syndrome are lacking. The present study showed that metabolic syndrome was associated with worsening renal function at long-term follow-up and the stone-recurrence rate recurrence after PCNL in patients with metabolic syndrome was 3.2-fold higher compared with the control group. OBJECTIVE: • To investigate the impact of metabolic syndrome on long-term kidney function and stone recurrence rates after percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: • In all, 73 patients with metabolic syndrome who underwent stone analysis and had a minimum follow-up of 12 months after PCNL were reviewed. • In addition, 73 patients without any metabolic syndrome components who had undergone PCNL and were followed-up for at least 12 months were included in the study as the control group. • These control group patients were selected from 226 patients who were matched with the patients with metabolic syndrome using a 1 : 1 ratio. The matching parameters were age, gender and stone size. RESULTS: • Stone analyses showed that calcium oxalate monohydrate (52.0%) and uric acid (21.9%) were most common among patients with metabolic syndrome, whereas calcium oxalate monohydrate (76.7%) was the most common stone type in the control group. • Stone recurrences occurred with a mean (sd, range) of 36.1 (21.3, 12-109) months follow-up in 26 patients (41.9%) and 12 patients (18.9%) in the metabolic syndrome and control groups, respectively (P= 0.003). • While estimated glomerular filtration rate was decreased from 87.8 to 66.6 mL/min/1.73 m(2) in the metabolic syndrome group, it changed from 96.4 to 91.2 mL/min/1.73 m(2) in control group at long-term follow-up. CONCLUSIONS: • The most frequent stone type was calcium oxalate monohydrate in patients with or without metabolic syndrome. • In patients with metabolic syndrome who underwent PCNL, the stone recurrence rate was >40%. • Metabolic syndrome is associated with worsening renal function at long-term follow-up.
BJU International 10/2012; · 2.84 Impact Factor
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Medical Hypotheses 09/2012; · 1.39 Impact Factor
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Urological Research 09/2012; · 1.23 Impact Factor
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ABSTRACT: Purpose: We present our initial experience with microperc in patients with moderate size renal calculi. Methods: A retrospective analysis of 30 patients (male: 14, female: 16) with moderate-sized (1-3 cm) kidney stones who underwent microperc between August 2011 and July 2012 was performed. The demographic values, peri-operative and postoperative measures including age, stone size and location, body-mass index (BMI), operation and fluoroscopy time, hemoglobin decrease, success and complication rates were prospectively recorded into a patient entry system. Results: The average stone size was 17.9 ± 5.0 mm (10-30). The mean age of the patients was 41.5 ± 18.2 years (range: 3-69). The duration of the operation was calculated as 63.5 ± 36.8 (range: 20-200) minutes. Mean fluoroscopic screening time was 150.5 ± 90.4 seconds (range: 45-360). The patients were discharged after a mean hospitalization period of 35.5 ± 18.6 (range: 14-96) hours. An overall success rate of 93% (including 10% of insignificant residual fragment rate) was achieved. In the follow-up, residual stone fragments were detected in 2 patients (7%). Conversion to miniperc was necessitated in 3 patients (10%). The mean hemoglobin drop was found to be 1.1 ± 0.8 (range: 0-2.8) mg/dL. Complications were observed in 5 patients (13.3%). Conclusions: Our initial results provide that microperc is a feasible, safe and efficacious treatment modality for moderate sized kidney stones as well as small ones with its minimal invasive nature. Technical refinements are required to achieve better results and overcome the limitations of technique.
Journal of endourology / Endourological Society 09/2012; · 1.75 Impact Factor
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Urology 09/2012; 80(3):745-6; author reply 746. · 2.43 Impact Factor
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ABSTRACT: Abstract Background and Purpose: The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance rates. We present our experience with microperc in the treatment of LP renal calculi. Patients and Methods: We retrospectively evaluated the symptomatic patients with LP renal calculi who underwent microperc between August 2011 and June 2012 from two referral hospitals. Patients were included only in cases of failure after shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) and according to patient preference. The percutaneous renal access was performed using the 4.8F "all-seeing needle" with C-arm fluoroscopy or ultrasonographic guidance with the patient in the prone position. Stone disintegration was established using a 200 μm holmium:yttrium-aluminum-garnet laser fiber. Results: A total of 21 patients (mean age 37.3±20.1 years) with LP stone underwent microperc. The mean body mass index was 28.6±6.0 kg/m(2), and the mean stone size was 17.8±5.9 (9-29) mm. The duration of surgery and fluoroscopic screening was 62.8±25.2 minutes and 150.5±92.8 seconds, respectively. The patients were discharged after a mean 37.5±14.4 hours of hospitalization time. The mean hemoglobin drop was 0.8±0.6 (0.1-2.3) g/dL. Conversion to miniperc was necessitated in one patient with loss of vision. Stone-free status was achieved in 18 (85.7%) patients. Clinically insignificant residual fragments were observed in only one (4.8%). The procedure failed in two (9.5%) patients. A total of two minor complications (renal colic necessitating stent insertion and urinary tract infection) were observed postoperatively, none severe. Conclusion: Microperc is a feasible and efficient treatment modality for symptomatic LP calculi. Our results provide that microperc might take a part in case of SWL and RIRS failures or as an alternative to percutaneous nephrolithotomy or RIRS in the management of symptomatic LP calculi.
Journal of endourology / Endourological Society 08/2012; · 1.75 Impact Factor
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ABSTRACT: OBJECTIVE: To present the feasibility and safety of fluoro-less endoscopic treatment of ureteral stones to diminish radiation exposure of the patient and operating team, and to determine circumstances where a fluoroscopic imaging is mandatory. METHODS: Between 2010 and 2011, 93 patients with ureteral calculi who underwent ureteroscopic treatment by experienced urologists were retrospectively evaluated. Manipulations, such as guidewire, ureteral stent insertion, and balloon dilatation were performed with visual and tactile cues. Patient demographics, need for fluoroscopic imaging, operation and fluoroscopy time, and complication and success rates were investigated. RESULTS: The mean age of patients was 34.03 ± 12.09 years (range, 9-63 years). The mean stone size was 10.64 ± 3.16 mm (range, 6-17 mm). The stones were localized in the proximal, middle, and distal segments in 11, 30, and 52 patients, respectively. The mean duration of the operation was 34.51 ± 7.94 minutes (range, 24-55 minutes). Stone-free status was achieved for 90 patients (96.77%). Fluoroscopic imaging was required for 7 patients with a mean fluoroscopy time of 9 ± 4.72 seconds (range, 4-16 seconds) for the following reasons: stone migration to the kidney (3 patients), double collecting system with 2 ureters (1 patient), and ureteral orifice stricture extending to the upper segment (1 patient). No major complications were observed, but minor complications were observed in 11 patients (11.8%). CONCLUSION: The ureteroscopic treatment of ureteral stones can be safely and effectively performed in experienced hands, with limited or no usage of fluoroscopy except in special circumstances, such as anatomic abnormalities, upper ureteral strictures, and impacted ureteral stones leading to ureteral tortuosity, kinking, and obstruction.
Urology 07/2012; · 2.43 Impact Factor
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ABSTRACT: PURPOSE: During PNL procedures, stone clearance can be achieved by single access or multiple accesses for same stone size and configuration. At this point, we believed that pelvicaliceal system type may play a significant role on stone clearance. In our study, we aimed to investigate the effect of pelvicaliceal system type on PNL outcomes. METHODS: A total of 498 patients who had preoperative intravenous urography were enrolled in our study. PCSs of the patients were classified as A1, A2, B1, and B2 according to Sampaio system after evaluation of IVU images. The exclusion criteria were unclassified pelvicaliceal system due to the presence of exaggerated renal hydronephrosis, IVUs with poor quality, radiolucent renal stones, and absence of CT or IVU in postoperative period. RESULTS: There was no clinically significant difference for patient gender, history of open surgery, and history of previous SWL. Success rates of PNL were 79.5, 82.0, 74.3, and 80.3 % in Sampaio type A1, A2, B1, and B2 PCS, respectively (p 0.61). Multiple accesses were required for 35 (18.8 %), 14 (17.9 %), 55 (30.1 %), and 6 (11.8 %) patients according to Sampaio classification type A1, A2, B1, and B2, respectively (p 0.008). There was no clinically significant difference for stone size, stone configuration (simple or complex), and complications. CONCLUSION: Sampaio type B1 PCSs require increased number of access for achieving stone clearance. Therefore, surgeons should be aware and also inform patients that treatment of patients with Sampaio type B1 PCS may need high number of access during PNL procedure.
World Journal of Urology 07/2012; · 2.41 Impact Factor
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Urological Research 07/2012; 40(5):557. · 1.23 Impact Factor
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ABSTRACT: Study Type - Therapy (RCT) Level of Evidence 1a What's known on the subject? and What does the study add? Standard monopolar transurethral resection of prostate (TURP) remains the gold standard surgical treatment of benign prostatic hyperplasia-related lower urinary tract symptoms. Bipolar salin TURP offers rapid tissue removal and haemostasis during resection with better vision under saline irrigation while eliminating risk of TUR syndrome. Few prospective randomized studies have investigated the effect of bipolar and monopolar TURP on erectile function. The study found that bipolar saline TURP is a safe and effective procedure that is associated with a significantly shorter operating time, a smaller reduction in serum sodium levels and similar efficacy compared with conventional monopolar TURP. OBJECTIVE: • To evaluate the outcomes of bipolar vs conventional monopolar transurethral resection of the prostate (TURP) on urinary and erectile function. MATERIAL AND METHODS: • A total of 286 patients with benign prostatic hyperplasia (BPH) were randomized to bipolar or monopolar conventional TURP treatment groups. • Operative and early postoperative variables and complications were recorded and all patients were re-evaluated at 1, 3, 6 and 12 months after surgery using the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual urine volume (PVR) and the erectile function domain of the International Index of Erectile Function (IIEF-ED). • A comparative evaluation of erectile function was performed on 188 preoperatively non-catheterized patients with regular sexual partners. RESULTS: • The operating time was shorter in the bipolar TURP group. Postoperative bleeding and blood transfusion requirements did not significantly differ between the two groups. Sodium levels were significantly lower in the monopolar group than in the bipolar group. • Transuretheral resection syndrome developed in two (1.4%) patients in the monopolar group. Both groups had similar and significantly improved IPSS values, maximum urinary flow rate values and PVR measurement. • ED worsened in 32 (17.0%) patients, improved in 53 (28.2%) patients, and was unchanged in 103 (54.8%) patients. Changes in the IIEF scores during the follow-up period were similar between the bipolar and monopolar groups. CONCLUSION: • Bipolar TURP is a safe and effective procedure that is associated with a significantly shorter operating time, a smaller reduction in serum sodium levels and a similar efficacy compared with conventional monopolar TURP.
BJU International 06/2012; · 2.84 Impact Factor
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ABSTRACT: Abstract Purpose: To compare sulbactam-ampicillin and cefuroxime antibiotics for prophylaxis of percutaneous nephrolithotomy (PCNL) and to find out the optimal regimen for antibiotic maintenance to prevent systemic inflammatory response syndrome (SIRS). Patients and Methods: Between February 2010 and March 2011, a total of 198 patients in whom PCNL was performed were prospectively randomized into two main groups regarding the type of prophylactic antibiotic (group1: sulbactam-ampicillin, group 2: cefuroxime). Each group was further randomized according to duration of antibiotic maintenance (a: single dose prophylaxis, b: additional dose 12 hours after prophylaxis, c: beginning with prophylactic dose until the nephrostomy tube removal). Seven patients in whom purulent urine was obtained through the access needle were excluded from the study. Groups were compared in terms of stone- and operation-related factors as well as preoperative urine cultures, access cultures, stone cultures, postoperative urine cultures, and presence of SIRS. Results: A total of 191 patients (group 1: 95, group 2: 96) were evaluated. Mean patient age, body mass index, stone size, and perioperative outcomes were similar. Positive culture rates did not differ between groups. SIRS was observed in 13 (43.3%) patients in group 1 and 17 patients (56.7%) in group 2 (P=0.44). The relation between duration of antibiotic maintenance and SIRS development was not different in each group (P=0.95 for group 1, P: 0.39 for group 2). Urosepsis was observed in two patients, and one patient died because of septic shock. Conclusions: Sulbactam-ampicillin and cefuroxime antibiotics can be used safely for prophylaxis of PCNL. Single dose administration is sufficient.
Journal of endourology / Endourological Society 05/2012; · 1.75 Impact Factor
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ABSTRACT: There are few studies of the long-term outcome of percutaneous nephrolithotomy for staghorn calculi. We report the long-term outcome of percutaneous nephrolithotomy in patients with staghorn calculi.
A total of 265 study patients (272 renal units) were followed in the long term for greater than 12 months. The estimated glomerular filtration rate was calculated using the 4-variable modification of diet in renal disease equation. Cases were staged for chronic kidney disease by National Kidney Foundation guidelines. The impact of patient and procedure related factors on renal function as well as stone recurrence was analyzed retrospectively.
At a mean ± SD followup of 37.3 ± 25.4 months the chronic kidney disease stage classification was maintained in 177 patients (66.8%) while the classification of 34 (12.8%) and 54 (20.4%) had improved and deteriorated, respectively. Multivariate analysis revealed that an immediate postoperative change in the estimated glomerular filtration rate was the only factor predicting a change in renal function in the long term. Stones recurred in 73 of the 234 kidneys (31.2%) that were stone free 3 months after percutaneous nephrolithotomy. Stone size increased in 24 of the 38 kidneys (63.2%) with residual stones after intervention. Recurrent urinary infections during followup and diabetes were associated with stone recurrence and residual stone enlargement.
In almost 80% of patients with staghorn stones renal function was improved or maintained after percutaneous nephrolithotomy, as documented during long-term followup. Stones recurred in a third of the patients with staghorn calculi.
The Journal of urology 03/2012; 187(5):1656-61. · 4.02 Impact Factor
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ABSTRACT: Laparoscopic nephrectomy has become the gold standard procedure for nonfunctioning or symptomatic benign kidneys due to renal calculi, obstructive, refluxive, and inflammatory nephropathies or renovascular hypertension. We aimed to investigate the effect of renal calculi as a reason of non-functioning on the progress and complication rates of the retroperitoneoscopic nephrectomy (RPN).During a 2-year period, 108 patients with benign renal conditions underwent RPN by single surgeon. Among these patients, total of 27 (Group 1) with a non-functioning kidney due to renal calculi were retrospectively compared with 27 patients (Group 2) with other benign renal conditions. The two groups were matched for age, body mass index, and previous renal surgery. We analyzed operative and post-operative findings and complications. The mean age and the BMI of the groups were similar. The operation time was significantly longer in Group 1 than Group 2 (p = 0.0001). There was no significant difference between the groups with respect to mean hemoglobin drop postoperatively (p = 0.9) and hospitalization time (p = 0.06). The perioperative and postoperative complication rates were higher in Group 1 but not statistically different from Group 2 (p = 0.19, p = 0.29, respectively). RPN for nonfunctioning calculous kidneys is more challenging procedure and is associated with prolonged operation time related to difficult dissection of dense adhesions. It can be safely performed by experienced hands with similar perioperative and postoperative complication rates as well as for other benign conditions of the kidney.
Urological Research 02/2012; 40(5):559-65. · 1.23 Impact Factor
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ABSTRACT: The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could find a place in the management of large renal pelvic stones which are generally considered as excellent indications for percutaneous nephrolithotomy (PNL). Between 2006 and 2009, 26 consecutive patients with large (>4 cm(2)) renal pelvic stones were treated by LPL and their charts were compared to 26 match-paired patients treated with PNL during the same period. The patients were matched for age, BMI, stone size and location as well as presence of congenital anomalies. Perioperative and postoperative findings were compared. The mean age, mean stone size, rate of congenital anomalies, history open renal surgery and shock wave lithotripsy were similar in both groups (p > 0.05). The mean operation time was 138.40 ± 51.19 (range 70-240) min in LPL group as compared to 57.92 ± 21.12 (range 40-110) min in PNL group (p < 0.0001). There was one (3.8%) open conversion in the LPL group due to dense perirenal adhesions making the dissection difficult. The ureteropelvic junction (UPJ) obstruction concomitant to pelvic stones was successfully repaired laparoscopically in two cases. The mean drop in postoperative hemoglobin level was 0.9 ± 0.6 (range 0-2) g/dl in LPL group and 1.7 ± 1.1 (range 0-4) g/dl in PNL group (p = 0.024). Hospitalization was significantly shorter in PNL than LPL group (p = 0.0001). Stone-free rates were similar. Laparoscopic pyelolithotomy is associated with a longer operation time, is more invasive, and requires more skills when compared to PNL. However, LPL is associated with less blood loss. Laparoscopic pyelolithotomy is indicated for congenitally anomalous kidneys and especially in patients with concomitant UPJ.
Urological Research 02/2012; 40(5):549-55. · 1.23 Impact Factor
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ABSTRACT: Percutaneous nephrolithotomy (PCNL) is regarded as the gold standard for the treatment of patients with renal stones larger than 2 cm in diameter. Creating a percutaneous renal access is the initial and probably the most important step in performing a PCNL. Two primary methods of obtaining proper percutaneous renal access under fluoroscopic guidance are described: The "triangulation" and the "eye of the needle" techniques. In this article, we compare these two techniques in terms of success and complication rates.
From October 2010 to May 2011, 80 patients with simple renal stones were prospectively randomized into two groups according to the percutaneous renal access technique used for PCNL. Patients in group 1 (n=40) were assigned to the eye of the needle technique, and patients in group 2 (n=40) were assigned to the triangulation method. Patients needing multiple access points were excluded from the study. The preoperative, operative, and postoperative follow-up findings were thereafter analyzed and compared.
No significant difference between the two groups was detected in terms of patient demographics (mean patient age, body mass index, stone size, or stone location). The operation time, fluoroscopic screening time (FST), and duration of hospitalization were similar in both groups (P=0.52, P=0.32, P=0.26, respectively). Patients in group 1 had a larger drop in hematocrit postoperatively than patients in group 2 (7.6 ± 3.7 vs 4.8 ± 2.1, P=0.001). The blood transfusion rate (7.5%) was similar in both groups, however. Although the complication rate was higher in group 1 than group 2, no significant difference was detected (20% vs 15%, P=0.76).
The present study demonstrates that PCNL can be performed safely using two different percutaneous access techniques. The two techniques studied in this trial had similar FSTs, operation and hospitalization times, success rates, and complication rates.
Journal of endourology / Endourological Society 01/2012; 26(7):828-33. · 1.75 Impact Factor
