[Percutaneous Stone Treatment Today: Standard-, Mini-, Micro-, Ultramini-PCNL].

Abstract:

BACKGROUND:Percutaneous nephrolithotripsy (PCNL) is one of the main interventional treatment modalities for large kidney stones (> 2 cm diameter). With the implementation of miniaturised techniques the indications for PCNL have been broadened to smaller stones. Especially for urologists without emphasis on endourology it is difficult to have an overview of the growing multitude of available systems and techniques. This article describes the currently available systems for percutaneous stone treatment with their peculiarities and indications. MATERIALS AND METHODS:A PubMed-based literature search has been conducted. Relevant articles and additional manufacturers' literature have been compiled to create a summary of the different available PCNL systems. Furthermore, a brief literature review is given regarding indications, stone-free rates and complication rates of each system category. RESULTS:Several manufacturers have developed different PCNL systems with varying diameters and special features. The indications for the different systems are overlapping. Retrospective studies showed reduced complication rates (especially less bleeding and need for transfusions) but prospective randomised controlled trials on this topic are still lacking. Assessed with the criteria of evidence-based medicine, the currently available evidence does not clearly answer the question whether a miniaturisation of PCNL systems is advantageous for the patient. CONCLUSION:Invasiveness of PCNL can be reduced with the nowadays available miniaturised systems. The indication for PCNL has been broadened to small kidney stones > 1 cm diameter.

journal_name

Aktuelle Urol

journal_title

Aktuelle Urologie

authors

Wilhelm K,Fritsche HM,Netsch C,AG „Endourologie und Urolithiasis“ der GeSRU Academics.

doi

10.1055/s-0035-1555863

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

297-302

issue

4

eissn

0001-7868

issn

1438-8820

journal_volume

46

pub_type

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