Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1243-1250
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1243
Perioperative and long-term results of ultrasonography-guided single- and multiple-tract percutaneous nephrolithotomy for staghorn calculi
Rui-Xiang Cheng, Ni Dai, Yan-Min Wang, Pei Qi, Fen Chen
Rui-Xiang Cheng, Department of Urology, Wuhan Ninth Hospital, Wuhan 430081, Hubei Province, China
Ni Dai, Department of Urinary Pain, Wuhan Hankou Hospital, Wuhan 430000, Hubei Province, China
Yan-Min Wang, Pre-hospital Emergency Department, Wuhan Puren Hospital, Wuhan 430081, Hubei Province, China
Pei Qi, Department of Orthopedic Trauma Surgery, Wuhan Hankou Hospital, Wuhan 430000, Hubei Province, China
Fen Chen, Department of Ultrasound, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan 430015, Hubei Province, China
Co-first authors: Rui-Xiang Cheng and Ni Dai.
Author contributions: Cheng RX and Dai N designed and performed the experiments, and writing the manuscript; Wang YM, Qi P provided support for data analysis, resource, and discussion; Chen F provided the supervision, design and peer review process; all the authors have seen and approved the manuscript.
Institutional review board statement: This study protocol was approved by Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, and all the families have voluntarily participated in the study and have signed informed consent forms.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declared no conflict of interest existing in this paper.
Data sharing statement: Data generated from this investigation are available upon reasonable quest from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fen Chen, MM, Attending Doctor, Department of Ultrasound, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, No. 11 Lingjiaohu Road, Jianghan District, Wuhan 430015, Hubei Province, China. fchen0919@163.com
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 8, 2023
Revised: November 29, 2023
Accepted: January 17, 2024
Article in press: January 17, 2024
Published online: March 6, 2024
Abstract
BACKGROUND

It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention. Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy (M-PCNL) has a similar stone free rate (SFR) as standard percutaneous nephrolithotomy (S-PCNL). As a result, M-PCNL was also recommended as a treatment option for staghorn calculi.

AIM

To examine the perioperative and long-term results of ultrasonography-guided single- and M-PCNL.

METHODS

This was a retrospective cohort study. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy. The primary outcomes were complication rate and SFR, and the characteristics of patients, operative parameters, laboratory measurements were also collected.

RESULTS

In total, 345 patients were enrolled in the study (186 in the S-PCNL group and 159 in the M-PCNL group). The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group (P = 0.033). Moreover, the incidence rates of hydrothorax (P = 0.03) and postoperative infection (P = 0.012) were higher in the M-PCNL group than in the S-PCNL group. Logistic regression analysis demonstrated that post-operative white blood cell count (OR = 2.57, 95%CI: 1.90-3.47, P < 0.001) and stone size (OR = 1.59, 95%CI: 1.27-2.00, P < 0.001) were associated with a higher overall complication rate in the S-PCNL group. Body mass index (OR = 1.22, 95%CI: 1.06-1.40, P = 0.004) and stone size (OR = 1.70, 95%CI: 1.35-2.15, P < 0.001) were associated with increased overall complications in the M-PCNL group.

CONCLUSION

Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.

Keywords: Single-tract percutaneous nephrolithotomy, Multiple-tract percutaneous nephrolithotomy, Staghorn calculi, Ultrasonography

Core Tip: It is estimated that 1% to 15% of the population will suffer from kidney stones during their lifetime. Incidences of urinary tract stones are on the rise. The number of Americans with renal stone disease reached 10.6% among men and 7.1% among women in 2012 according to the National Health and Nutrition Examination Survey. In a retrospective study, we examined the perioperative and long-term results of ultrasonography-guided single-tract percutaneous nephrolithotomy (PCNL) and multiple-tract PCNL. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi by using PCNL. Multiple-access tracts can facilitate higher stone free rate while increasing the incidence of acceptable complications slightly.