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Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial

OBJECTIVE: To compare the outcome of treatment planning using multislice computed tomography (CT) or intravenous urography (IVU) for supine percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: The study included 60 patients with renal stones, all treated by supine PCNL, between March 2011 and...

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Autores principales: El-Wahab, Osama A., El-Tabey, Magdy A., El-Barky, Ehab, El-Baky, Shabieb A., El-Falah, Adel, Refaat, Medhat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434608/
https://www.ncbi.nlm.nih.gov/pubmed/26019942
http://dx.doi.org/10.1016/j.aju.2013.11.005
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author El-Wahab, Osama A.
El-Tabey, Magdy A.
El-Barky, Ehab
El-Baky, Shabieb A.
El-Falah, Adel
Refaat, Medhat
author_facet El-Wahab, Osama A.
El-Tabey, Magdy A.
El-Barky, Ehab
El-Baky, Shabieb A.
El-Falah, Adel
Refaat, Medhat
author_sort El-Wahab, Osama A.
collection PubMed
description OBJECTIVE: To compare the outcome of treatment planning using multislice computed tomography (CT) or intravenous urography (IVU) for supine percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: The study included 60 patients with renal stones, all treated by supine PCNL, between March 2011 and October 2012. The patients were divided randomly into two equal groups; in group 1 30 patients had the PCNL access planned based on IVU findings, and in group 2 the PCNL access was planned based on multislice CT images. All patients were suitable for PCNL, based on a plain abdominal film and ultrasonography, and with a body mass index of <30 kg/m(2). The exclusion criteria were renal anomalies and bleeding diathesis. All data from both groups for the mean time taken to gain percutaneous access, operative duration, fluoroscopic time, access difficulty, stone-free rate and intraoperative morbidity were collected and analysed statistically. RESULTS: The mean (SD) time taken to gain percutaneous access was longer in group 1 than group 2, at 22.2 (1.76) vs. 13.1 (1.62) min (P < 0.001), as were the operative duration, at 81.9 (14.9) vs. 58.8 (7.6) min (P < 0.001), and fluoroscopic time, at 3.5 (1.7) vs. 2.2 (1.3) min (P = 0.002). In group 1 there were four cases (13%) in which there were difficulties in establishing percutaneous access, while in group 2 there were none (P = 0.003). There was intraoperative morbidity in three patients (10%) in group 1 and two (7%) in group 2. CONCLUSION: Multislice CT is a safer, more accurate and noninvasive imaging technique than IVU for mapping the pelvicalyceal system. It saves time and is essential in choosing the optimal percutaneous access into the pelvicalyceal system for a safe and successful PCNL.
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spelling pubmed-44346082015-05-27 Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial El-Wahab, Osama A. El-Tabey, Magdy A. El-Barky, Ehab El-Baky, Shabieb A. El-Falah, Adel Refaat, Medhat Arab J Urol Stones / Endourology Original article OBJECTIVE: To compare the outcome of treatment planning using multislice computed tomography (CT) or intravenous urography (IVU) for supine percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: The study included 60 patients with renal stones, all treated by supine PCNL, between March 2011 and October 2012. The patients were divided randomly into two equal groups; in group 1 30 patients had the PCNL access planned based on IVU findings, and in group 2 the PCNL access was planned based on multislice CT images. All patients were suitable for PCNL, based on a plain abdominal film and ultrasonography, and with a body mass index of <30 kg/m(2). The exclusion criteria were renal anomalies and bleeding diathesis. All data from both groups for the mean time taken to gain percutaneous access, operative duration, fluoroscopic time, access difficulty, stone-free rate and intraoperative morbidity were collected and analysed statistically. RESULTS: The mean (SD) time taken to gain percutaneous access was longer in group 1 than group 2, at 22.2 (1.76) vs. 13.1 (1.62) min (P < 0.001), as were the operative duration, at 81.9 (14.9) vs. 58.8 (7.6) min (P < 0.001), and fluoroscopic time, at 3.5 (1.7) vs. 2.2 (1.3) min (P = 0.002). In group 1 there were four cases (13%) in which there were difficulties in establishing percutaneous access, while in group 2 there were none (P = 0.003). There was intraoperative morbidity in three patients (10%) in group 1 and two (7%) in group 2. CONCLUSION: Multislice CT is a safer, more accurate and noninvasive imaging technique than IVU for mapping the pelvicalyceal system. It saves time and is essential in choosing the optimal percutaneous access into the pelvicalyceal system for a safe and successful PCNL. Elsevier 2014-06 2013-12-18 /pmc/articles/PMC4434608/ /pubmed/26019942 http://dx.doi.org/10.1016/j.aju.2013.11.005 Text en © 2014 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Stones / Endourology Original article
El-Wahab, Osama A.
El-Tabey, Magdy A.
El-Barky, Ehab
El-Baky, Shabieb A.
El-Falah, Adel
Refaat, Medhat
Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title_full Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title_fullStr Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title_full_unstemmed Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title_short Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: A randomised clinical trial
title_sort multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: a randomised clinical trial
topic Stones / Endourology Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434608/
https://www.ncbi.nlm.nih.gov/pubmed/26019942
http://dx.doi.org/10.1016/j.aju.2013.11.005
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