Single site multi puncture supine (SMS) PCNL procedure in patient with complex renal stone: One incision, why should more?

Published: November 21, 2024
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Introduction: Since percutaneous nephrolithotomy (PCNL) was introduced in 1976, it has been the standard procedure for large renal stones. Over time, the PCNL technique changed and developed into various techniques. We introduce single site multipuncture supine (SMS) PCNL to give cosmetic advantage due to less tissue injury in complex renal stone. This study aimed to determine the outcome SMS PCNL procedure in patients with complex renal stones diseases.
Materials and methods: This study was a retrospective study including all patients with kidney stones who had undergone SMS PCNL at the Urology Department of Saiful Anwar General Hospital from March 2019 until December 2022. All SMS PCNL procedures were performed by a single operator. The patients were divided into three groups that included that were treated with 2, 3, and 4 punctures. The data were collected using SPSS ver. 25.
Results: Ninety-three patients were included in this study. The characteristics of the patient such as gender, age, BMI were not significantly different among the groups. The outcome of SMS PCNL procedure showed low complication rate during operation in 2-,3-,and 4-puncture groups (3.2%, 7.4%, 0%, respectively). The Stone Free Rate (SFR) showed no significant difference between the 3 groups (p = 0.496). The SFR was 85.7% in 2-puncture, 77.8% in 3-puncture, 66.7% in 4-puncture group. The AUC of Guy’s Stone Score with cut off value was 3.5 (AUC = 0.549, p-value = 0.541, CI 95%).
Conclusions: Single Site Multi Puncture PCNL is safe and efficient approach to complex renal stones. Single Site Multipunctures Supine PCNL is comparable with other techniques of PCNL and gives minimal tissue injury that would benefit for cosmetic.

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Citations

Shalaby MM, Abdala MA, Aboul-Ella HA, et al. Single puncture percutaneus nephrolithomy for management of complex renal stones. BMC Res Notes. 2009; 2:62.
Liang T, Zhao C, Wu G, et al. Multi tract percutaneus nephrolithotomy combined with EMS Lithotripsy for bilateral complex renal stones: our experience. BMC Urology. 2017; 17:1-5.
Verma A, Tomar V, Yadav S. Complex multiple renal calculi: tone distribution, pelvicalyceal anatomy and site of puncture as
predictor of PCNL outcome. Springerplus 2016; 5:1356.
Lezrek M, Bazine K, Ammani A, et al. Needle renal displacement techinque for the percutaneus approach to the superior calix. J Endourol. 2011; 25:1723-1726.
Thomas K, Smith NC, Hegarty N, Glass JM. The Guy’s stone score- Grading the complexity of percutaneous nephrolithotomy procedures. Urology 2011; 78:277-81.
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann. Surg. 2009; 250:187-196.
Ilham M. Paksi S, Andri K. A novel technique single site multipunctures supine PCNL: case series report. Jurnal Urologi Indonesia 2024; 31:55-60.
Ermis O, Bhaskar S, Thomas R, et al. Definition, treatment and outcome of residual fragments in staghorn stones. Asian J Urol. 2020;7:116-21.
Hegarty NJ, Desai MM. Percutaneus nephrolithotomy requiring multiple tracts: comparison of morbiditiy with single tract procedures. J Endourol. 2006; 20:753-60.
Akman T, Binbay M, Sari E, et al. Factor affecting bleeding during percutaneus nephrolithotomy: single surgeon experience. J Endourol. 2011; 25:327-333.
Elawady H, Mostafa DE, Mahmoud MA, et al. Is multiple tracts percutaneous nephrolithotomy (PCNL) safe modality in management of complex renal stones? A prospective study: Single center experience.African J Urol. 2018; 24:308-314.
Jiao B, Ding Z, Luo Z, et al. Single- versus multiple-tract percutaneous nephrolithotomy in the surgical management of staghorn stones or complex caliceal calculi: A systematic review and metaanalysis. Biomed Res Int. 2020; 2020:8817070.
Labadie K, Okhunov Z, Akhavein A, et al. Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery. J Urol. 2015; 193:154-159.
Kumar U, Tomar V, Yadav SS, et al. STONE score versus Guy's Stone Score - prospective comparative evaluation for success rate and complications in percutaneous nephrolithotomy. Urol Ann. 2018;10:76-81.

How to Cite

Satyagraha, P., Nur Budaya, T., & Amorga, R. (2024). Single site multi puncture supine (SMS) PCNL procedure in patient with complex renal stone: One incision, why should more?. Archivio Italiano Di Urologia E Andrologia. https://doi.org/10.4081/aiua.2024.13156