alexa Natural history of residual fragments following percutaneous nephrostolithotomy
Surgery

Surgery

Medical & Surgical Urology

Author(s): Raman JD, Bagrodia A, Gupta A

Abstract Share this page

PURPOSE: We reviewed the natural history of residual fragments after percutaneous nephrostolithotomy. MATERIALS AND METHODS: From April 1999 to January 2007 a total of 728 patients underwent percutaneous nephrostolithotomy at our medical center including 527 with a minimum documented radiographic followup of 6 months. Of these patients 42 (8%) with residual fragments on postoperative computerized tomography were observed rather than subjected to second look flexible nephroscopy. Computerized tomography was reviewed to define location, size and number of residual fragments. The primary study end point was a stone related event defined as growth of a residual fragment, or need for emergency room visit, hospitalization or additional intervention attributable to the residual fragment. Univariate and multivariate analyses were performed to determine predictors of a stone related event. RESULTS: The median residual fragment size was 2 mm (range, 1 to 12). There were 18 patients (43%) who experienced a stone related event at a median of 32 months after percutaneous nephrostolithotomy (range 4 to 95). On univariate analysis residual fragment location in the renal pelvis or ureter (p = 0.02), maximum residual fragment size larger than 2 mm (p = 0.03) and cumulative residual fragment size (p = 0.03) predicted a stone related event. On multivariate analysis only maximum residual fragment size larger than 2 mm (HR 3.9, p = 0.01) and location in the renal pelvis or ureter (HR 4.4, p = 0.01) independently predicted a stone event. CONCLUSIONS: The size and location of post-percutaneous nephrostolithotomy residual fragments correlate with stone related events. Larger fragments are more likely to require secondary surgical intervention. Second look flexible nephroscopy may be of benefit in patients with residual fragments larger than 2 mm or in those with fragments located in the renal pelvis or ureter.

This article was published in J Urol and referenced in Medical & Surgical Urology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords