The "mini-perc" technique: a less invasive alternative to percutaneous nephrolithotomy.
The disadvantages of standard percutaneous nephrolithotomy (PCNL) as compared with ureteroscopy or extracorporeal shock-wave lithotripsy include increased blood loss, greater pain, and longer hospital stay. A 13-Fr "mini-perc" technique using a ureteroscopy sheath for PCNL was developed in an attempt to address these drawbacks. Nine "mini-percs" have been performed in patients aged 40-73 years with stone burdens of < or = 2 cm2. On average, patients had 1.4 stones with a cross-sectional area of 1.5 cm2. The mean total procedure time, estimated blood loss, and hematocrit decrease were 176 min, 83 ml, and 6.6%, respectively. On average, patients used 14 mg of parenteral morphine and stayed 1.7 days in the hospital. There was no procedure-related complication or transfusion. Eight of nine kidneys (89%) were stone-free on early follow-up at a mean of 3.8 weeks. As compared with standard PCNL, the "mini-perc" technique has similar early success rates in selected patients and may offer advantages with respect to hemorrhage, postoperative pain, and shortened hospital stays.
Jackman
S V
SV
James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD 21287-2101, USA.
Docimo
S G
SG
Cadeddu
J A
JA
Bishoff
J T
JT
Kavoussi
L R
LR
Jarrett
T W
TW
D000328:Adult; D000368:Aged; D019723:Endoscopes; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011860:Radiography, Abdominal; D016896:Treatment Outcome; D020709:Ureteroscopes