RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?

I read with great interest the article “Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?” by Ozgor et al.[1] This article highlights an interesting outcome of isolated calyceal stones which were managed by percutaneous nephrolithotomy (PCNL). The...

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Main Author: Kamarulzaman, Mohd Nazli
Format: Article
Language:English
Published: Turkish Association of Urology 2016
Subjects:
Online Access:http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/1/115-116.pdf
id iium-50704
recordtype eprints
spelling iium-507042017-01-15T18:15:27Z http://irep.iium.edu.my/50704/ RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location? Kamarulzaman, Mohd Nazli RD Surgery I read with great interest the article “Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?” by Ozgor et al.[1] This article highlights an interesting outcome of isolated calyceal stones which were managed by percutaneous nephrolithotomy (PCNL). The isolated upper pole calyceal stone has been shown to have statistically significant difference in term of thoracic complications, longer nephrostomy duration, and hospital stay in comparison to middle calyceal stone. Besides that, post-operative bleeding also appeared to be higher and stone clearance rate was lower in upper pole puncture but there was no statistically significant difference between the groups. All those parameters suggest that the direct puncture for treating isolated upper pole calyceal stone has higher risks with lower effectiveness. In my opinion a definite conclusion cannot be drawn from this study as it was a retrospective review which had some limitations. In this study various modifications of conventional PCNL as a special measure was not clearly elaborated. The use of balloon dilatation and single stage dilatation with Amplatz dilator was found to have less bleeding in comparison to serial Amplatz dilatation.[2] Whereas properly selected site and timing of the puncture was found to reduce the thoracic complications. Ko et al.[3] found that careful placing the puncture site at lateral half of the ribs will avoid pleural and supracostal puncture. Whereas, puncturing kidney during fully expiration will push the lung base two interspaces higher. Both tricks will avoid from puncturing pleura, thus reduce thoracic complications. Turkish Association of Urology 2016 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50704/1/115-116.pdf Kamarulzaman, Mohd Nazli (2016) RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location? Turkish Journal of Urology, 42 (2). pp. 115-116. ISSN 2149-3235 E-ISSN 2149-3057 http://www.turkurolojidergisi.com/sayilar/162/buyuk/115-116.pdf 10.5152/tud.2016.84565
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic RD Surgery
spellingShingle RD Surgery
Kamarulzaman, Mohd Nazli
RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
description I read with great interest the article “Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?” by Ozgor et al.[1] This article highlights an interesting outcome of isolated calyceal stones which were managed by percutaneous nephrolithotomy (PCNL). The isolated upper pole calyceal stone has been shown to have statistically significant difference in term of thoracic complications, longer nephrostomy duration, and hospital stay in comparison to middle calyceal stone. Besides that, post-operative bleeding also appeared to be higher and stone clearance rate was lower in upper pole puncture but there was no statistically significant difference between the groups. All those parameters suggest that the direct puncture for treating isolated upper pole calyceal stone has higher risks with lower effectiveness. In my opinion a definite conclusion cannot be drawn from this study as it was a retrospective review which had some limitations. In this study various modifications of conventional PCNL as a special measure was not clearly elaborated. The use of balloon dilatation and single stage dilatation with Amplatz dilator was found to have less bleeding in comparison to serial Amplatz dilatation.[2] Whereas properly selected site and timing of the puncture was found to reduce the thoracic complications. Ko et al.[3] found that careful placing the puncture site at lateral half of the ribs will avoid pleural and supracostal puncture. Whereas, puncturing kidney during fully expiration will push the lung base two interspaces higher. Both tricks will avoid from puncturing pleura, thus reduce thoracic complications.
format Article
author Kamarulzaman, Mohd Nazli
author_facet Kamarulzaman, Mohd Nazli
author_sort Kamarulzaman, Mohd Nazli
title RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
title_short RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
title_full RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
title_fullStr RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
title_full_unstemmed RE: Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?
title_sort re: percutaneous nephrolithotomy for isolated calyceal stones: how important is the stone location?
publisher Turkish Association of Urology
publishDate 2016
url http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/
http://irep.iium.edu.my/50704/1/115-116.pdf
first_indexed 2023-09-18T21:11:42Z
last_indexed 2023-09-18T21:11:42Z
_version_ 1777411295612502016