medigraphic.com
ISSN 0016-3813 (Print)

2019, Number 1

<< Back Next >>

Gac Med Mex 2019; 155 (1)

Tasa libre de litos sin complicación mayor como definición de éxito en nefrolitotomía percutánea

Moreno-Palacios J, Avilés-Ibarra OJ, López-Samano VA, Rivas-Ruiz R, Rodríguez-Silverio J, Maldonado-Alcaraz E

Language: Spanish
References: 28
Page: 52-57
PDF size: 240.43 Kb.


ABSTRACT

Introduction: Success in percutaneous nephrolithotomy (PCNL) is defined as a stone-free status; however, major complications are highly common and have been reported as a secondary outcome. Objective: To propose a new definition of PCNL success that comprises a stone free rate without major complications and a risk scale to predict this outcome. Methods: Historical cohort of patients undergoing PCNL. The included variables were age, gender, urine culture, Charlson’s comorbidity index (CCI) and complex stones. Success was defined as a stone free status with or without Clavien grade ≤ 2 complication; intermediate success: with stones, with or without Clavien grade ≤ 2 complication; and failure: with or without stones with Clavien grade ≤ 2 complication. Bivariate analysis was performed to identify which factors are associated with the outcome. The independent weight of each factor was calculated by multiple logistic regression analysis. Results: 568 procedures were included, 59% of which were in females. Median age was 49 years; 65%, 22% and 13% of cases were classified as success, intermediate success and failure, respectively. Female sex, positive urine culture, complex stones and severe CCI were associated with failure. Conclusions: The likelihood of success was directly proportional to the number of risk factors.


REFERENCES

  1. Bartoletti R, Cai T, Mondaini N, Melone F, Travaglini F, Carini M, et al. Epidemiology and risk factors in urolithiasis. Urol Int. 2007;79:3-7.

  2. Ramello A, Vitale C, Marangella M. Epidemiology of nephrolithiasis. J Nephrol. 2000;13:S45-S50.

  3. Türk C, Petrik A, Sarica K, Seitz C, Straub M, Traxer O, et al. EAU Guidelines on Urolithiasis. Países Bajos: European Association of Urology; 2010.

  4. Pradere B, Doizi S, Proietti S, Brachlow J, Traxer O. Evaluation of guidelines for surgical management of urolithiasis. J Urol. 2018;199:1267-1271.

  5. De la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol. 2011;25:11-17.

  6. Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R. A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol. 2012;26:52-57.

  7. Opondo D, Gravas S, Joyce A, Pearle M, Matsuda T, Sun YH, et al. Standardization of patient outcomes reporting in percutaneous nephrolithotomy. J Endourol. 2014;28:767-774.

  8. Thomas K, Smith NC, Hegarty N, Glass JM. The Guy’s stone score: grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78:277-281.

  9. Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, et al. S.T.O N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology. 2013;81:1154-1159.

  10. Smith A, Averch TD, Shahrour K, Opondo D, Daels FP, Labate G, et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013;190:149-156.

  11. De la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012;62 246-255.

  12. Moreno-Palacios J, Maldonado-Alcaraz E, Montoya-Martínez G, Rivas- Ruiz R, Cedillo-Lopez U, Okhunov Z, et al. Prognostic factors of morbidity in patients undergoing percutaneous nephrolithotomy. J Endourol. 2014;28:1078-1084.

  13. Olvera-Posada D, Tailly T, Alenezi H, Violette PD, Nott L, Denstedt JD, et al. Risk factors for postoperative complications of percutaneous nephrolithotomy at a tertiary referral center. J Urol. 2015;194:1646-1651.

  14. Labate G, Modi P, Timoney A, Cormio L, Zhang X, Louie M, et al. The percutaneous nephrolithotomy global study: classification of complications. J Endourol. 2011;25:1275-1280.

  15. Unsal A, Resorlu B, Atmaca AF, Diri A, Goktug HN, Can CE, et al. Prediction of morbidity and mortality after percutaneous nephrolithotomy by using the Charlson Comorbidity Index. Urology. 2012;79:55-60.

  16. Rivera M, Viers B, Cockerill P, Agarwal D, Mehta R, Krambeck A. Pre- and postoperative predictors of infection-related complications in patients undergoing percutaneous nephrolithotomy. J Endourol. 2016; 30:982-986.

  17. Tiselius HG, Andersson A. Stone burden in an average Swedish population of stone formers requiring active stone removal: how can the stone size be estimated in the clinical routine? Eur Urol. 2003;43:275-281.

  18. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373-1379.

  19. Labadie K, Okhunov Z, Akhavein A, Moreira DM, Moreno-Palacios J, Del-Junco M, et al. Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery. J Urol. 2015;193:154-159.

  20. Seitz C, Desai M, Häcker A, Hakenberg OW, Liatsikos E, Nagele U, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol. 2012;61:146-158.

  21. Tefekli A, Ali Karadag M, Tepeler K, Sari E, Berberoglu Y, Baykal M, et al. Classification of percutaneous nephrolithotomy complications using the modified clavien grading system: looking for a standard. Eur Urol. 2008;53:184-190.

  22. De la Rosette JJ, Zuazu JR, Tsakiris P, Elsakka AM, Zudaire JJ, Laguna MP, et al. Prognostic factors and percutaneous nephrolithotomy morbidity: a multivariate analysis of a contemporary series using the Clavien classification. J Urol. 2008;180 2489-2493.

  23. Okeke Z, Smith AD, Labate G, D’Addessi A, Venkatesh R, Assimos D, et al. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients. J Endourol. 2012;26 996-1001.

  24. Frenk J, Gómez-Dantés O, Langer A. A comprehensive approach to women’s health: lessons from the Mexican health reform. BMC Womens Health. 2012;12:42.

  25. Gutierrez J, Smith A, Geavlete P, Shah H, Kural AR, De-Sio M, et al. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy. World J Urol. 2013;31:1135-1140.

  26. Resorlu B, Diri A, Atmaca AF, Tuygun C, Oztuna D, Bozkurt OF, et al. Can we avoid percutaneous nephrolithotomy in high-risk elderly patients using the Charlson comorbidity index? Urology. 2012;79:1042-1047.

  27. Desai M, De Lisa A, Turna B, Rioja J, Walfridsson H, D’Addessi A, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: staghorn versus nonstaghorn stones. J Endourol. 2011;25:1263-1268.

  28. Deters LA, Jumper CM, Steinberg PL, Pais VM. Evaluating the definition of “stone free status” in contemporary urologic literature. Clin nephrol. 2011;76:354-357.




2020     |     www.medigraphic.com