Research and Reports in Urology (Feb 2024)
The Outcome of the Miniaturized Percutaneous Nephrolithotomy in Lateral Position with Guidance of Non-Rotational C-Arm
Abstract
Ngoc Hung Pham,1 Vuong Thang Hoang,1 Cong Le Kha Bui,1 Van Quoc Anh Nguyen,1 Van Can Truong,1 Lance J Hampton2 1Department of Urology, Hue Central Hospital, Hue, Vietnam; 2Division of Urology, Massey Cancer Center, VCU Health, Richmond, VA, USACorrespondence: Ngoc Hung Pham, Department of Urology, Hue Central Hospital, 16 Le Loi street, Vinh Ninh ward, Hue City, Thua Thien Hue Province, Vietnam, Email [email protected]: Evaluation of the outcome of the miniaturized percutaneous nephrolithotomy in the treatment of nephrolithiasis with a lateral position based on the principle of a right triangle under the guidance of a C-Arm without contrast fluid.Materials and Methods: Sixty-nine cases of Mini-PCNL with the assistance of a vacuum-assisted sheath in the lateral position were performed at Central Hospital from March 2021 to August 2022. Percutaneous renal access was under the guidance of a non-rotational C-arm without contrast medium, and we determined the puncture location and depth of the needle based on the principle of right triangles.Results: The median age was 51.6 ± 12.5 years, and males accounted for 68.1% of the cases. 60.9% of all patients had normal weight. The median stone surface area was 361.1mm2, and 59.4% of all cases were graded as 2 regarding Guy’s stone score. The successful renal access rate was 100%. The tunnel access from the middle and lower calyx accounted for 94.2%. The median access duration, fluoroscopy duration, and hospital length of stay were 271.7 seconds, 14.79 seconds, and 6.3 days, respectively. The complete stone clearance rate was 78.3%. Bleeding complications occurred in 2 patients without mortality. Three patients required an additional procedure.Conclusion: The puncture technique into the renal calyxes based on the principle of the right triangle under the guidance of a non-rotational C-Arm without contrast medium in PCNL is a fast, exact, and safe technique.Keywords: MiniPCNL, percutaneous renal access, non-rotational C-arm, flank position, vacuum-assisted sheath
