Military Medical Research (Oct 2024)
International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy
- Guo-Hua Zeng,
- Wen Zhong,
- Giorgio Mazzon,
- Wei Zhu,
- Sven Lahme,
- Sanjay Khadgi,
- Janak Desai,
- Madhu Agrawal,
- David Schulsinger,
- Mantu Gupta,
- Emanuele Montanari,
- Juan Manuel Lopez Martinez,
- Shabir Almousawi,
- Vincent Emanuel F. Malonzo,
- Seshadri Sriprasad,
- Chu Ann Chai,
- Vimoshan Arumuham,
- Stefania Ferretti,
- Wissam Kamal,
- Ke-Wei Xu,
- Fan Cheng,
- Xiao-Feng Gao,
- Ji-Wen Cheng,
- Bhaskar Somani,
- Mordechai Duvdevani,
- Kah Ann Git,
- Christian Seitz,
- Norberto Bernardo,
- Tarek Ahmed Amin Ibrahim,
- Albert Aquino,
- Takahiro Yasui,
- Cristian Fiori,
- Thomas Knoll,
- Athanasios Papatsoris,
- Nariman Gadzhiev,
- Ulanbek Zhanbyrbekuly,
- Oriol Angerri,
- Hugo Lopez Ramos,
- Iliya Saltirov,
- Mohamad Moussa,
- Guido Giusti,
- Fabio Vicentini,
- Edgar Beltran Suarez,
- Margaret Pearle,
- Glenn M. Preminger,
- Qing-Hui Wu,
- Otas Durutovic,
- Khurshid Ghani,
- Marcus Maroccolo,
- Marianne Brehmer,
- Palle J. Osther,
- Marek Zawadzki,
- Azimdjon Tursunkulov,
- Monolov Nurbek Kytaibekovich,
- Abdusamad Abdukakhorovich Abuvohidov,
- Cesar Antonio Recalde Lara,
- Zamari Noori,
- Stefano Paolo Zanetti,
- Sunil Shrestha,
- Jean de la Rosette,
- John Denstedt,
- Zhang-Qun Ye,
- Kemal Sarica,
- Simon Choong
Affiliations
- Guo-Hua Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University
- Wen Zhong
- Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University
- Giorgio Mazzon
- Department of Urology, San Bassiano Hospital
- Wei Zhu
- Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University
- Sven Lahme
- Department of Urology, Siloah St. Trudpert Hospital
- Sanjay Khadgi
- Department of Urology, Vayodha Hospital
- Janak Desai
- Department of Urology, Muljibhai Patel Urological Hospital
- Madhu Agrawal
- Department of Urology, Centre for Minimally-Invasive Endourology, Global Rainbow Healthcare
- David Schulsinger
- Department of Urology, Stony Brook University School of Medicine
- Mantu Gupta
- Department of Urology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System
- Emanuele Montanari
- Department of Urology, Fondazione IRCSS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan
- Juan Manuel Lopez Martinez
- Department of Urology, Barcelona Clinical Hospital
- Shabir Almousawi
- Department of Urology, Sabah Al Ahmad Urology Centre
- Vincent Emanuel F. Malonzo
- Department of Surgery, Section of Urology, Veterans Memorial Medical Center
- Seshadri Sriprasad
- Department of Urology, Darent Valley Hospital
- Chu Ann Chai
- Department of Urology, University of Belgrade
- Vimoshan Arumuham
- Department of Urology, Stone and Endourology Unit, University College London Hospitals NHS Foundation Trust
- Stefania Ferretti
- Department of Urology, Hospital, University of Parma
- Wissam Kamal
- Department of Urology, King Fahd Hospital
- Ke-Wei Xu
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
- Fan Cheng
- Department of Urology, Renmin Hospital of Wuhan University
- Xiao-Feng Gao
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University
- Ji-Wen Cheng
- Department of Urology, Affiliated Tumor Hospital of Guangxi Medical University
- Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Trust
- Mordechai Duvdevani
- Department of Urology, Hadassah Hebrew University Hospital
- Kah Ann Git
- Department of Urology, Pantai Hospital
- Christian Seitz
- Department of Urology, Vienna General Hospital, Medical University of Vienna
- Norberto Bernardo
- Department of Urology, Hospital de Clinicas Jose de San Martin
- Tarek Ahmed Amin Ibrahim
- Department of Urology, Hamad Medical Corporation
- Albert Aquino
- Department of Urology, Jose R. Reyes Memorial Medical Center
- Takahiro Yasui
- Department of Nephrourology, Nagoya City University Graduate School of Medical Sciences
- Cristian Fiori
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital
- Thomas Knoll
- Department of Urology, Klinikum Sindelfingen-Boeblingen, University of Tuebingen
- Athanasios Papatsoris
- Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens
- Nariman Gadzhiev
- Department of Urology, Saint-Petersburg State University Hospital
- Ulanbek Zhanbyrbekuly
- Department of Urology and Andrology, Astana Medical University
- Oriol Angerri
- Department of Urology, Puigvert Foundation, Autonomous University of Barcelona
- Hugo Lopez Ramos
- Department of Urology, San Ignacio University Hospital
- Iliya Saltirov
- Department of Urology and Nephrology, Military Medical Academy
- Mohamad Moussa
- Department of Urology, Al Zahraa Hospital University Medical Center and Lebanese University
- Guido Giusti
- Department of Urology, IRCCS San Raffaele Hospital
- Fabio Vicentini
- Department of Urology, Endourology and Stone Disease Section, University of Sao Paulo Medical School
- Edgar Beltran Suarez
- Department of Urology, Specialty Hospital La Raza, National Medical Center of the Mexican Institute of Social Security
- Margaret Pearle
- Department of Urology, UT Southwestern Medical Center
- Glenn M. Preminger
- Division of Urologic Surgery, Duke University Medical Center
- Qing-Hui Wu
- Department of Urology, National University Hospital
- Otas Durutovic
- Department of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade
- Khurshid Ghani
- Department of Urology, Division of Endourology, University of Michigan
- Marcus Maroccolo
- Department of Urology, Hospital de Base of the Federal District
- Marianne Brehmer
- Department of Urology, Karolinska University Stockholm Sweden and Aarhus University Hospital
- Palle J. Osther
- Department of Urology, Lillebaelt Hospital, University of Southern Denmark
- Marek Zawadzki
- Department of Urology, St. Anna Hospital
- Azimdjon Tursunkulov
- Department of Urology, Akfa Medline Hospital
- Monolov Nurbek Kytaibekovich
- Department of Urology, DOC University Clinic
- Abdusamad Abdukakhorovich Abuvohidov
- Department of Urology, Tajik State Medical University
- Cesar Antonio Recalde Lara
- Department of Urology, Tte. Ettiene 215
- Zamari Noori
- Department of Urology, Aria Apollo Hospital
- Stefano Paolo Zanetti
- Department of Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan
- Sunil Shrestha
- Department of Surgery, Nepal Medical College Teaching Hospital
- Jean de la Rosette
- Department of Urology, Istanbul Medipol University
- John Denstedt
- Department of Surgery, Division of Urology, Western University, Schulich School of Medicine and Dentistry
- Zhang-Qun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Kemal Sarica
- Department of Urology, Medical School, Biruni University
- Simon Choong
- Department of Urology, University College Hospital of London
- DOI
- https://doi.org/10.1186/s40779-024-00562-3
- Journal volume & issue
-
Vol. 11,
no. 1
pp. 1 – 11
Abstract
Abstract Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts’ experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.
Keywords
- Percutaneous nephrolithotomy (PCNL)
- Miniaturized PCNL (mPCNL)
- Expert consensus
- Kidney stone
- Operation
