Browsing by Author "Skolarikos, Andreas (6602103893)"

Percutaneous nephrolithotomy (PCNL) is frequently used as the first-line treatment of large and complex stones. The key point for successful complex stone removal with minimal risk of complications is to establish the most appropriate access route. Understanding the three-dimensional (3D) relationship of kidney stones and renal collecting systems is crucial for planning and creating an optimal access route. By using a 3D volume segmentation tool a more accurate approach to the renal collecting system and stone treatment could be planned. The objective of this study was assessing the impact of 3D software in getting the desired access. Copyright © 2022 Durutović, Filipović, Milićević, Somani, Emiliani, Skolarikos and Janković.

To compare the total fluoroscopy time (FT) based on the fluoroscopy mode used—continuous vs. pulsed—in patients who underwent percutaneous nephrolithotomy (PCNL). The study cohort evaluated 111 patients who underwent PCNL by a single surgeon. Standard (continuous) fluoroscopy of 30 frames per second (fps) was used in the first 56 cases (SF group), while the next 55 consecutive cases were performed under pulsed fluoroscopy of two fps (PF group). The presence of surgeon’s previous experience decreased the possible impact of the learning curve on the outcome. In both groups, using ultrasound in combination to fluoroscopy performed the renal access. The stone complexity was determined using Guy’s stone score (GSS). Complications were evaluated using Clavien-Dindo classification. Median FT was significantly lower in PF group (76.8 s) compared to SF group (155.4 s) (p < 0.001). Stone-free rate was related to the Guy’s stone score (GSS) classification reaching 100 % in GSS 1 cases in both groups. In GSS 2 cases the stone free rate was 87.5 % in SF group, while in PF group it was 92.3 %. Stone free rate in GSS 3 cases was 73.3 and 85.7 % in SF and PF groups, respectively. In cases of GSS 4 stone free rate was 52 % in SF group and 55.6 % in PF group, respectively. Presence of residual fragments and complications were comparable in both groups. Following ultrasound-guided puncture during PCNL, the use of pulsed fluoroscopy leads to significantly lower radiation exposure comparing to the use of continuous fluoroscopy. This advantage does not compromise the safety and efficacy of the procedure. © 2016, Springer-Verlag Berlin Heidelberg.