Volume 13, Supplement 1
Original Article / Published: April 2025
DOI: https://www.doi.org/10.57045/jemis/1310425.pp23-25
K. Hristov, K. Petkova, D. Petrova, V. Todorova, O. Gatsev, I. Saltirov
Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria
Abstract
Introduction & Aim: With the recent advancements in endoscopic technologies, the technique of minimally invasive PCNL with a smaller access sheath emerged in an effort to reduce renal parenchymal injury during the procedure. However, the reduction in sheath diameter resulted in reduced irrigation and visualization and precluded the extraction of bigger stone fragments. In an effort to improve vision, irrigation and fragments extraction, a modified access sheath with active aspiration was developed in different sheath sizes to allow the use of a variety of miniaturized nephroscopes. The aim of our study is to evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (Mini PNL) with aspiration sheath in the treatment of kidney stones.
Materials and methods: The medical records of 50 patients who underwent Mini PNL with aspiration sheath for the treatment of kidney stones were retrospectively reviewed. The patients were treated at the Clinic of Urology, Military Medical Academy, Sofia, between January 2024 and July 2024. Data on patients` preoperative characteristics, stone–free rates, complications and auxiliary procedures were analyzed.
Results: Patients` mean age was 54.5 ± 11.4 years. The mean stone size was 35.1.2±6.7 mm and the male-to-female ratio was 66/34 %. Fourteen of the patients (28%) had an anticoagulant therapy that was stopped a week before the operation. The mean preoperative value of the haemoglobin was 136.2±17.5 g/l. There were no intraoperative complications. The mean hospital stay was 3.33±0.9 days. The mean value of the postoperative haemoglobin was 127.2±14.8 g/l. The mean Hgb drop was 9.9±5.8 g/l. The stone-free rate after the operation was 82 %. Postoperative complications were observed in 6 cases (12%). 4 (8%) of the complications were classified as grade 2 according to Clavien-Dindo classification and 2 (4%) as grade 3a ( 1 case treated with embolization and 1 with stent JJ placement).
Conclusions: The minimally invasive percutaneous nephrolithotomy has established itself as an effective and safe method for the treatment of kidney stones. The application of a modified access sheath with active aspiration ensures effective evacuation of the fragments and increases the stone-free rates in patients.
References
Keywords:
urolithiasis, percutaneous nephrolithotomy, efficacy, safety
How to cite this article:
K. Hristov, K. Petkova, D. Petrova, V. Todorova, O. Gatsev, I. Saltirov. Efficacy and safety of the minimally invasive percutaneous nephrolithotomy with aspiration sheath in the treatment of kidney stones. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2025; 13(1): 24-25
Corresponding author:
Dr. Konstantin Hristov
Clinic of Urology
Department of Urology and Nephrology, Military Medical Academy
Address: Sofia 1606, 3, Georgi Sofiyski Blvd.
Email: konstantin.hristovv@gmail.com