The Outcome of the Miniaturized Percutaneous Nephrolithotomy in Lateral Position with Guidance of Non-Rotational C-Arm

Figures & data

Figure 1 The Double-J stent (White) was placed simultaneously with ureteral catheter (Blue).

Figure 2 The patient was in lateral position.

Figure 3 The way of puncture according to the principle of square triangles (A): location of targeted stones; (B): is the projection of A on the dorsal plane when the C-arm is perpendicular to this plane; (C): needle entry point.

Figure 4 The way to determine (A, B and C) on CTScan based on the principle of right triangles.

Figure 5 The vacuum-assisted sheath.

Figure 6 The continuous renal irrigation pump system.

Table 1 Demographic and Clinical Characteristics

All Patients (n=69)
	Count	% of Total
Age
21–40	15	21.7
41–60	41	59.4
>60	13	18.8
Gender
Males	47	68.1
Females	22	31.9
BMI classification
Underweight	4	5.8
Normal weight	42	60.9
Overweight	23	33.3
Previous urological treatment
ESWL	2	2.9
PCNL	4	5.8
RIRS	1	1.4
Open	16	23.2
Clinical symptoms on admission
Acute renal colic	25	36.2
Pain in the flanks and backs	39	56.5
UTIs	3	4.3
Hematuria	3	4.3
Kidney side
Right	31	44.9
Left	38	55.1
Hydronephrosis
Grade 0	28	40.6
Grade 1	16	23.2
Grade 2	20	29
Grade 3	5	7.2
Position of renal stone
Renal pelvis	9	13
Renal calyx	19	27.5
Renal calyxes	8	11.6
Complex renal stone	33	47.8
Number of renal stone
1 stone	19	27.5
≥ 2 stones	50	72.5
Guy’s Stone Score
1	16	23.3
2	41	59.4
3	12	17.4
4	0	0
Stone surface area (mm2)
< 400	37	53.6
400 - < 800	23	33.3
800 - < 1600	9	13.1
≥ 1600	0	0
Kidney failure
Yes	7	10.1
No	62	89.9
Urinary leukocytes
Negative	31	44.9
Positive	38	51.1
Urinary nitrite
Negative	60	87
Positive	9	13
Urinary culture
Negative	64	92.8
Positive	5	7.2

Abbreviations: BMI, Body Mass Index; ESWL, Extracorporeal shock wave lithotripsy; PCNL, Percutaneous nephrolithotomy; RIRS, Retrograde intrarenal surgery; UTIs, Urinary tract infection.

Table 2 Intraoperative Characteristics

All Patients (n=69)
	Count	% of Total
Position of puncture
Upper calyx	4	5.8
Middle calyx	42	60.9
Lower calyx	23	33.3
Number of punctures for renal access
1 time	60	87
2 times	7	10.1
3 times	2	2.9
The angle of puncture (Degree)
< 45	0	0
45–60	41	59.4
> 60	28	40.6
Double-J Stenting
Antegrade	23	33.3
Retrograde	38	55.1
No	8	11.6
Percutaneous puncture duration (seconds)
< 30	10	14.5
30–60	5	7.2
> 60	54	78.3
Dilation time (minutes)
< 3	26	37.7
3–6	42	60.9
> 6	1	1.4
Fluoroscopy duration (seconds)
< 20	61	88.4
20–30	4	5.8
30–40	1	1.4
> 40	3	4.3
Operation time (minutes)
< 60	1	1.4
60–120	19	27.5
> 120	49	71.1

Table 3 Postoperative Characteristics

Variables	Mean ± SD
Length of postoperative hospital stay (days)	6.30 ± 3.27
Time of removing nephrostomy (days)	2.39 ± 1.69
Postoperative RBC (M/μL)	4.25 ± 0.57
Postoperative Hemoglobin (g/dL)	12.66 ± 1.69
	Count	% of Total
Postoperative Complications
Fever	7	10.1
Bleeding	2	2.9
Clavien–Dindo classification of surgical complications
Grade 0	53	76.8
Grade I	9	13.1
Grade II	5	7.2
Grade IIIa	2	2.9

Abbreviations: RBC: Red blood cell; SD: Standard deviation.

Table 4 Follow-Up Characteristics

All Patients (n=69)
	Count	% of total
Clinical Symptoms
Pain in flank and back	3	4.3
Hematuria	1	1.4
Dysuria	1	1.4
Stone free status 1 month after surgery
Yes	54	78.3
No	15	21.7
Hydronephrosis status 1 month after surgery
Grade 0	28	40.6
Grade 1	38	55.1
Grade 2	3	4.3
Grade 3	0	0
Surgical outcome
Good	44	63.7
Average	25	36.3
Poor	0	0