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Mahmoud R Elkenawy - One of the best experts on this subject based on the ideXlab platform.
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factors affecting Stone free rate and complications of percutaneous nephrolithotomy for treatment of Staghorn Stone
Urology, 2012Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A Shokeir, Ibrahim Eraky, Ahmed M Shoma, Shady A Soliman, Hamdy A Elkappany, Mahmoud R ElkenawyAbstract:Objective To determine factors affecting the Stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of Staghorn Stones. Methods The computerized database of patients who underwent PNL for treatment of Staghorn Stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The Stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting Stone-free and complication rates. Results The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral Stones). The Stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the Stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual Stones were complete Staghorn Stone and presence of secondary calyceal Stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion Factors affecting the incidence of residual Stones after PNL are complete Staghorn Stones and the presence of secondary calyceal Stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.
Ahmed R Elnahas - One of the best experts on this subject based on the ideXlab platform.
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percutaneous nephrolithotomy for Staghorn Stones a randomised trial comparing high power holmium laser versus ultrasonic lithotripsy
BJUI, 2016Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A ShokeirAbstract:Objective To compare high-power holmium laser lithotripsy (HP-HLL) and ultrasonic lithotripsy (US-L) for disintegration of Staghorn Stones during percutaneous nephrolithotomy (PCNL). Patients and Methods A non-inferiority randomised controlled trial was conducted between August 2011 and September 2014. Inclusion criteria were patients' aged >18 years who had complete Staghorn Stones (branching to the three major calyces), without contraindications to PCNL. Eligible patients were randomised between two groups: HP-HLL and US- . A standard PCNL in the prone position was performed for all patients. The only difference between the treatment groups was the method of Stone disintegration. In the first group (HP-HLL), a laser power of 40–60 W (2 J, 20–30 Hz) was used to pulverise the Staghorn Stone into very small fragments, which could pass through the Amplatz sheath with the irrigation fluid. US-L,with suction of the fragments, was used in the second group. The primary outcome (Stone-free rate) was evaluated with non-contrast computed tomography after 3 months. Secondary outcomes of complications, blood transfusion, operative time, and haemoglobin deficit were compared. The outcome assessor was ‘blinded’ to the treatment arm. Results The study included 70 patients (35 in each group). The baseline characteristics (age, sex, body mass index, side, Stone volume, and density) and operative technique (number, size of tracts, and need for second PCNL session) were comparable for both groups. Operative time was significantly shorter in US-L group, at a mean (SD) of 130 (34) vs 148.7 (35) min (P = 0.028). The haemoglobin deficit was significantly more with in the US-L group, at a mean (SD) of 1.7 (0.9) vs 1.3 (0.6) g/dL (P = 0.037). The differences in blood transfusion (17% for US-L vs 11% for HP-HLL) and the complication rates (34% for US-L vs 23% for HP-HLL) were not significant (P = 0.495 and P = 0.290, respectively). The Stone-free rates at 3 months were comparable (60% for US-L and 66% for HPL-L; P = 0.621). Conclusions Compared with US-L for intracorporeal lithotripsy of Staghorn Stones during PCNL, HP-HLL showed comparable safety and efficacy with a lower haemoglobin deficit but longer operative time.
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factors affecting Stone free rate and complications of percutaneous nephrolithotomy for treatment of Staghorn Stone
Urology, 2012Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A Shokeir, Ibrahim Eraky, Ahmed M Shoma, Shady A Soliman, Hamdy A Elkappany, Mahmoud R ElkenawyAbstract:Objective To determine factors affecting the Stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of Staghorn Stones. Methods The computerized database of patients who underwent PNL for treatment of Staghorn Stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The Stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting Stone-free and complication rates. Results The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral Stones). The Stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the Stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual Stones were complete Staghorn Stone and presence of secondary calyceal Stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion Factors affecting the incidence of residual Stones after PNL are complete Staghorn Stones and the presence of secondary calyceal Stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.
Ahmed Elassmy - One of the best experts on this subject based on the ideXlab platform.
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percutaneous nephrolithotomy for Staghorn Stones a randomised trial comparing high power holmium laser versus ultrasonic lithotripsy
BJUI, 2016Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A ShokeirAbstract:Objective To compare high-power holmium laser lithotripsy (HP-HLL) and ultrasonic lithotripsy (US-L) for disintegration of Staghorn Stones during percutaneous nephrolithotomy (PCNL). Patients and Methods A non-inferiority randomised controlled trial was conducted between August 2011 and September 2014. Inclusion criteria were patients' aged >18 years who had complete Staghorn Stones (branching to the three major calyces), without contraindications to PCNL. Eligible patients were randomised between two groups: HP-HLL and US- . A standard PCNL in the prone position was performed for all patients. The only difference between the treatment groups was the method of Stone disintegration. In the first group (HP-HLL), a laser power of 40–60 W (2 J, 20–30 Hz) was used to pulverise the Staghorn Stone into very small fragments, which could pass through the Amplatz sheath with the irrigation fluid. US-L,with suction of the fragments, was used in the second group. The primary outcome (Stone-free rate) was evaluated with non-contrast computed tomography after 3 months. Secondary outcomes of complications, blood transfusion, operative time, and haemoglobin deficit were compared. The outcome assessor was ‘blinded’ to the treatment arm. Results The study included 70 patients (35 in each group). The baseline characteristics (age, sex, body mass index, side, Stone volume, and density) and operative technique (number, size of tracts, and need for second PCNL session) were comparable for both groups. Operative time was significantly shorter in US-L group, at a mean (SD) of 130 (34) vs 148.7 (35) min (P = 0.028). The haemoglobin deficit was significantly more with in the US-L group, at a mean (SD) of 1.7 (0.9) vs 1.3 (0.6) g/dL (P = 0.037). The differences in blood transfusion (17% for US-L vs 11% for HP-HLL) and the complication rates (34% for US-L vs 23% for HP-HLL) were not significant (P = 0.495 and P = 0.290, respectively). The Stone-free rates at 3 months were comparable (60% for US-L and 66% for HPL-L; P = 0.621). Conclusions Compared with US-L for intracorporeal lithotripsy of Staghorn Stones during PCNL, HP-HLL showed comparable safety and efficacy with a lower haemoglobin deficit but longer operative time.
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factors affecting Stone free rate and complications of percutaneous nephrolithotomy for treatment of Staghorn Stone
Urology, 2012Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A Shokeir, Ibrahim Eraky, Ahmed M Shoma, Shady A Soliman, Hamdy A Elkappany, Mahmoud R ElkenawyAbstract:Objective To determine factors affecting the Stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of Staghorn Stones. Methods The computerized database of patients who underwent PNL for treatment of Staghorn Stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The Stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting Stone-free and complication rates. Results The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral Stones). The Stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the Stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual Stones were complete Staghorn Stone and presence of secondary calyceal Stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion Factors affecting the incidence of residual Stones after PNL are complete Staghorn Stones and the presence of secondary calyceal Stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.
Nasr Eltabey - One of the best experts on this subject based on the ideXlab platform.
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percutaneous nephrolithotomy for Staghorn Stones a randomised trial comparing high power holmium laser versus ultrasonic lithotripsy
BJUI, 2016Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A ShokeirAbstract:Objective To compare high-power holmium laser lithotripsy (HP-HLL) and ultrasonic lithotripsy (US-L) for disintegration of Staghorn Stones during percutaneous nephrolithotomy (PCNL). Patients and Methods A non-inferiority randomised controlled trial was conducted between August 2011 and September 2014. Inclusion criteria were patients' aged >18 years who had complete Staghorn Stones (branching to the three major calyces), without contraindications to PCNL. Eligible patients were randomised between two groups: HP-HLL and US- . A standard PCNL in the prone position was performed for all patients. The only difference between the treatment groups was the method of Stone disintegration. In the first group (HP-HLL), a laser power of 40–60 W (2 J, 20–30 Hz) was used to pulverise the Staghorn Stone into very small fragments, which could pass through the Amplatz sheath with the irrigation fluid. US-L,with suction of the fragments, was used in the second group. The primary outcome (Stone-free rate) was evaluated with non-contrast computed tomography after 3 months. Secondary outcomes of complications, blood transfusion, operative time, and haemoglobin deficit were compared. The outcome assessor was ‘blinded’ to the treatment arm. Results The study included 70 patients (35 in each group). The baseline characteristics (age, sex, body mass index, side, Stone volume, and density) and operative technique (number, size of tracts, and need for second PCNL session) were comparable for both groups. Operative time was significantly shorter in US-L group, at a mean (SD) of 130 (34) vs 148.7 (35) min (P = 0.028). The haemoglobin deficit was significantly more with in the US-L group, at a mean (SD) of 1.7 (0.9) vs 1.3 (0.6) g/dL (P = 0.037). The differences in blood transfusion (17% for US-L vs 11% for HP-HLL) and the complication rates (34% for US-L vs 23% for HP-HLL) were not significant (P = 0.495 and P = 0.290, respectively). The Stone-free rates at 3 months were comparable (60% for US-L and 66% for HPL-L; P = 0.621). Conclusions Compared with US-L for intracorporeal lithotripsy of Staghorn Stones during PCNL, HP-HLL showed comparable safety and efficacy with a lower haemoglobin deficit but longer operative time.
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factors affecting Stone free rate and complications of percutaneous nephrolithotomy for treatment of Staghorn Stone
Urology, 2012Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A Shokeir, Ibrahim Eraky, Ahmed M Shoma, Shady A Soliman, Hamdy A Elkappany, Mahmoud R ElkenawyAbstract:Objective To determine factors affecting the Stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of Staghorn Stones. Methods The computerized database of patients who underwent PNL for treatment of Staghorn Stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The Stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting Stone-free and complication rates. Results The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral Stones). The Stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the Stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual Stones were complete Staghorn Stone and presence of secondary calyceal Stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion Factors affecting the incidence of residual Stones after PNL are complete Staghorn Stones and the presence of secondary calyceal Stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.
Ahmed M Elshal - One of the best experts on this subject based on the ideXlab platform.
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percutaneous nephrolithotomy for Staghorn Stones a randomised trial comparing high power holmium laser versus ultrasonic lithotripsy
BJUI, 2016Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A ShokeirAbstract:Objective To compare high-power holmium laser lithotripsy (HP-HLL) and ultrasonic lithotripsy (US-L) for disintegration of Staghorn Stones during percutaneous nephrolithotomy (PCNL). Patients and Methods A non-inferiority randomised controlled trial was conducted between August 2011 and September 2014. Inclusion criteria were patients' aged >18 years who had complete Staghorn Stones (branching to the three major calyces), without contraindications to PCNL. Eligible patients were randomised between two groups: HP-HLL and US- . A standard PCNL in the prone position was performed for all patients. The only difference between the treatment groups was the method of Stone disintegration. In the first group (HP-HLL), a laser power of 40–60 W (2 J, 20–30 Hz) was used to pulverise the Staghorn Stone into very small fragments, which could pass through the Amplatz sheath with the irrigation fluid. US-L,with suction of the fragments, was used in the second group. The primary outcome (Stone-free rate) was evaluated with non-contrast computed tomography after 3 months. Secondary outcomes of complications, blood transfusion, operative time, and haemoglobin deficit were compared. The outcome assessor was ‘blinded’ to the treatment arm. Results The study included 70 patients (35 in each group). The baseline characteristics (age, sex, body mass index, side, Stone volume, and density) and operative technique (number, size of tracts, and need for second PCNL session) were comparable for both groups. Operative time was significantly shorter in US-L group, at a mean (SD) of 130 (34) vs 148.7 (35) min (P = 0.028). The haemoglobin deficit was significantly more with in the US-L group, at a mean (SD) of 1.7 (0.9) vs 1.3 (0.6) g/dL (P = 0.037). The differences in blood transfusion (17% for US-L vs 11% for HP-HLL) and the complication rates (34% for US-L vs 23% for HP-HLL) were not significant (P = 0.495 and P = 0.290, respectively). The Stone-free rates at 3 months were comparable (60% for US-L and 66% for HPL-L; P = 0.621). Conclusions Compared with US-L for intracorporeal lithotripsy of Staghorn Stones during PCNL, HP-HLL showed comparable safety and efficacy with a lower haemoglobin deficit but longer operative time.
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factors affecting Stone free rate and complications of percutaneous nephrolithotomy for treatment of Staghorn Stone
Urology, 2012Co-Authors: Ahmed R Elnahas, Ahmed M Elshal, Nasr Eltabey, Ahmed Elassmy, Ahmed A Shokeir, Ibrahim Eraky, Ahmed M Shoma, Shady A Soliman, Hamdy A Elkappany, Mahmoud R ElkenawyAbstract:Objective To determine factors affecting the Stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of Staghorn Stones. Methods The computerized database of patients who underwent PNL for treatment of Staghorn Stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The Stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting Stone-free and complication rates. Results The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral Stones). The Stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the Stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual Stones were complete Staghorn Stone and presence of secondary calyceal Stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion Factors affecting the incidence of residual Stones after PNL are complete Staghorn Stones and the presence of secondary calyceal Stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.
