Multitract Percutaneous Nephrolithotomy(PCNL) in Large Renal Stones.

Assiut University40 enrolled

Overview

Investigator aimed to analyze the clinical efficacy and safety of multiple tracts PCNL as one step therapy to treat the staghorn stones or multiple calyceal calculi which are inaccessible by single tract

Staghorn calculi are branched stones either partial or complete occupying the pelvis and one or more of the renal caliceal system that is detected by non contrast computrized tomography (NCCT) and plain on kidney, ureter, urinary bladder (KUB). An untreated staghorn calculus over time can damage the kidney and deteriorate its function and /or cause life threatening sepsis. Total stone clearance is an important goal to eradicate any infective focus, relieve obstruction and preserve the kidney function. Based on American Urological Association (AUA) guideline, PCNL is the most effective, safest and minimally invasive treatment option compared to open surgery

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Staghorn Calculi

Interventions

PCNLPROCEDURE

Percutaneous nephrolithotomy ( Extraction of the renal stones using the nephroscope/ Ureteroscope )

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Adult patients more than 18 years old. 2. Patients with staghorn stone (partial, complete). 3. Patients with multiple calyceal calculi which are inaccessible by single tract. Exclusion Criteria: 1. Patients under 18 years old. 2. Patients with renal anomalies. 3. Patients with only function kidney. 4. Patients with distal ureteric obstruction. 5. Patients with radiolucent stone. 6. Patients with febrile urinary tract infection. 7. Patients with abnormal coagulopathy state. 8. Patients refused to participate in this study. 9. pregnancy. 10. Musculoskeletal deformity.

Outcomes

Primary Outcomes

Stone free rate

Assessment of the instant postoperative stone free rate and after one month from the procedure for all 40 participants using the postoperative non contrast computerized tomography (NCCT )and plain on kidney , ureter, urinary bladder (KUB )

Time frame: The participants will be followed for one month after the procedure

Secondary Outcomes

Postoperative complications

Measuring the postoperative complications rates, classification of the severity of the complications will assess the safety of the procedure.

Time frame: From the start of the operation and till one month after the patient discharge.

Operative time

Measurment of the time from start of the operation till fixation of nephrostomy tube

Time frame: Average of three hours

Postoperative pain

Measurment of the postoperative pain score using the Visual analogue scale(VAS) that is divided into mild(1-3), moderate(4-6) and sever(7-10) according to the severity of the pain.

Time frame: Within 24 hours postoperative and till the patient discharge

Hospital stay

Postoperative hospital stay of the participants till thier discharge

Time frame: Average of six days

Central Contacts

Waleed Mahmoud Abbas, M.Sc

CONTACT

+2001009377858 Dr_walidws@yahoo.com

Mohamed Ali Zarzour, MD

CONTACT

+2001014714142 Dr-mohamedali81@yahoo.com

Data from ClinicalTrials.gov

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