ArticleWorld journal of urology2025
Percutaneous nephrolithotomy under total X-ray free technique in horseshoe kidney stones: a 10-year experience from a large stone center.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo report outcomes of complete ultrasound-guided percutaneous nephrolithotomy (PCNL) for horseshoe kidney (HSK) stones at a high-volume center and evaluate a novel technique (Needle-perc-assisted endoscopic surgery, NAES) for these patients. PATIENTS AND
methodsWe retrospectively reviewed all HSK stone patients who underwent PCNL at our institution over a 10-year period. The NAES technique was utilized during the most recent 4 years. Preoperative, intraoperative, and postoperative characteristics were analyzed, comparing traditional PCNL with NAES.
resultsSuccessful renal access was achieved in all 82 procedures. One-stage surgery was performed in 62 renal units (75.6%), while 20 (24.4%) required second-stage surgery. The final stone-free rate (SFR) was 74.4% (61/82). The prone position was predominantly used (96.3%), and the upper calyx was the initial target in 87.8% (72/82) of renal units. Residual stones were most frequently located in the isthmus (76.2%, 16/21) and lower calyx (23.8%, 5/21). Patients were stratified into NAES (n = 35) and conventional PCNL (n = 47) groups. The NAES group demonstrated significantly higher SFR (85.7% vs. 68.1%, p = 0.025), improved pain scores on postoperative day 1 (POD1), and shorter hospital stays.
conclusionComplete ultrasound-guided PCNL is safe and effective for HSK stones. The NAES technique significantly enhances stone clearance rates and improves patient outcomes in this cohort.
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