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International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Guohua ZengDepartment of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, China. [email protected]Wen ZhongGuangzhou Medical UniversityGiorgio MazzonDepartment of Urology, San Bassiano Hospital, 36061, Vicenza, ItalyWei ZhuDepartment of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, ChinaSven LahmeDepartment of Urology, Siloah St. Trudpert Hospital, 75179, Pforzheim, GermanySanjay KhadgiJanak DesaiDepartment of Urology, Muljibhai Patel Urological Hospital, Nadiad, 387001, IndiaMadhu AgrawalDavid A. SchulsingerDepartment of Urology, Stony Brook University School of Medicine, Stony Brook, NY, 11794, USAMantu GuptaDepartment of Urology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, 10029, USAE. MontanariDepartment of Urology, Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20122, Milan, ItalyJ. Martı́nezDepartment of Urology, Barcelona Clinical Hospital, 08036, Barcelona, SpainShabir AlmousawiDepartment of Urology, Sabah Al Ahmad Urology Centre, 20005, Kuwait, KuwaitVincent Emanuel F. MalonzoSeshadri SriprasadDepartment of Urology, Darent Valley Hospital, Dartford, DA2 8DA, UKChu Ann ChaiDepartment of Urology, University of Belgrade, 11120, Belgrade, SerbiaVimoshan ArumuhamDepartment of Urology, Stone and Endourology Unit, University College London Hospitals NHS Foundation Trust, London, NW1 2BU, UKStefania FerrettiDepartment of Urology, Hospital, University of Parma, 43126, Parma, ItalyWissam KamalDepartment of Urology, King Fahd Hospital, 23325, Jeddah, Saudi ArabiaKewei XuDepartment of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, ChinaFan ChengDepartment of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, ChinaXiaofeng GaoDepartment of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, 200433, ChinaJiwen ChengDepartment of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530022, ChinaBhaskar SomaniDepartment of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UKMordechai DuvdevaniDepartment of Urology, Hadassah Hebrew University Hospital, 91120, Jerusalem, IsraelKah Ann GitChristian SeitzMedical University of ViennaNorberto BernardoDepartment of Urology, Hospital de Clinicas Jose de San Martin, 1120, Buenos Aires, ArgentinaTarek IbrahimDepartment of Urology, Hamad Medical Corporation, 2001, Doha, QatarAlbert AquinoDepartment of Urology, Jose R. Reyes Memorial Medical Center, 1003, Manila, PhilippinesTakahiro YasuiDepartment of Nephrourology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 464-0083, JapanCristian FioriDepartment of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043, Orbassano, Turin, ItalyThomas KnollDepartment of Urology, Klinikum Sindelfingen-Boeblingen, University of Tuebingen, 71032, Tuebingen, GermanyAthanasios PapatsorisDepartment of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, 15126, Athens, GreeceNariman GadzhievDepartment of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia, 194100Ulanbek ZhanbyrbekulyDepartment of Urology and Andrology, Astana Medical University, 010000, Astana, KazakhstanOriol AngerriDepartment of Urology, Puigvert Foundation, Autonomous University of Barcelona, 08025, Barcelona, SpainHugo López‐RamosDepartment of Urology, San Ignacio University Hospital, 110231, Bogotá, ColombiaIliya SaltirovDepartment of Urology and Nephrology, Military Medical Academy, 1431, Sofia, BulgariaMohamad MoussaDepartment of Urology, Al Zahraa Hospital University Medical Center and Lebanese University, Beirut, 10001, LebanonGuido GiustiDepartment of Urology, IRCCS San Raffaele Hospital, Ville Turro Division, 20127, Milan, ItalyFábio C. VicentiniDepartment of Urology, Endourology and Stone Disease Section, University of Sao Paulo Medical School, Sao Paulo, 05508, BrazilEdgar Beltrán SuárezDepartment of Urology, Specialty Hospital La Raza, National Medical Center of the Mexican Institute of Social Security, 97217, Mexico City, MexicoMargaret S. PearleDepartment of Urology, UT Southwestern Medical Center, Dallas, TX, 75390, USAGlenn M. PremingerDivision of Urologic Surgery, Duke University Medical Center, Durham, NC, 27705, USAQinghui WuDepartment of Urology, National University Hospital, Singapore, 119074, SingaporeOtaš DurutovićDepartment of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, 112106, Belgrade, SerbiaKhurshid R. GhaniDepartment of Urology, Division of Endourology, University of Michigan, Ann Arbor, MI, 48109, USAMarcus Vinícius Osorio MaroccoloDepartment of Urology, Hospital de Base of the Federal District, Brasília, 70330-150, BrazilMarianne BrehmerDepartment of Urology, Karolinska University Stockholm Sweden and Aarhus University Hospital, 17176, Stockholm, DenmarkPalle Jørn Sloth OstherDepartment of Urology, Lillebaelt Hospital, University of Southern Denmark, 246000, Vejle, DenmarkMarek ZawadzkiDepartment of Urology, St. Anna Hospital, 05500, Piaseczno, PolandAzimdjon TursunkulovDepartment of Urology, Akfa Medline Hospital, 100211, Tashkent, UzbekistanMonolov Nurbek KytaibekovichAbdusamad Abdukakhorovich AbuvohidovDepartment of Urology, Tajik State Medical University, 734003, Dushanbe, TajikistanC. LaraZamari NooriS.P. ZanettiDepartment of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 28-20122, Milan, ItalySunil ShresthaDepartment of Surgery, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, 44600, NepalJean de la RosetteDepartment of Urology, Istanbul Medipol University, Istanbul, 34815, TurkeyJohn D. DenstedtDepartment of Surgery, Division of Urology, Western University, Schulich School of Medicine and Dentistry, London, ON, N6A 5C1, CanadaZhangqun YeDepartment of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430074, ChinaKemal SarıcaDepartment of Urology, Medical School, Biruni University, Istanbul, 34020, TurkeySimon ChoongDepartment of Urology, University College Hospital of London, London, NW1 2BU, UK. [email protected]

Military Medical Researchjournal2024en

ABI

Annotatsiya

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.

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Mavzular

Kidney Stones and Urolithiasis Treatments Pediatric Urology and Nephrology Studies Paleopathology and ancient diseases

Identifikatorlar

DOI: 10.1186/s40779-024-00562-3

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