[Minimally invasive PCNL (mini-perc). Alternative treatment modality or replacement of conventional PCNL?].
Extracorporeal shock wave lithotripsy (SWL) is the current treatment modality of choice for upper urinary tract calculi. For stones with a diameter >2 cm and in lower calyceal stones and diverticular stones, the stone-free rate of SWL is rather poor. In these cases, conventional percutaneous nephrolithotomy (PCNL) leads to an increased stone-free rate, but morbidity with conventional PCNL is significant higher than in SWL. With the invention of miniaturized nephroscopes (mini-perc), new treatment options are available. The experience based on hundreds of treatments using mini-perc show comparable results of mini-perc to conventional PCNL and a complication rate comparable to that for SWL. These favorable results are independent of stone size, stone location, and patient age. In summary, mini-perc can be recommended as a primary approach to stones of the upper urinary tract exceeding 1 cm, larger lower-pole stones, and calyceal diverticular stones. Mini-perc can be regarded as an alternative treatment modality to conventional PCNL.
Lahme
S
S
Klinik für Urologie, Krankenhaus St. Trudpert, Wolfsbergallee 50, 75175, Pforzheim, Deutschland. sven.lahme@trudpert.de
Zimmermanns
V
V
Hochmuth
A
A
Janitzki
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D008904:Miniaturization / Q000295:instrumentation*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D014567:Urography