Type:
Educational Exhibit
Keywords:
Abdomen, Gastrointestinal tract, Interventional non-vascular
Authors:
H. Stunell, C. Zwirewich, B. H. Chew, R. F. Paterson; Vancouver, BC/CA
DOI:
10.1594/ecr2011/C-1720
Conclusion
Fig.: Stone Centre
Since the opening of a dedicated the Stone Centre at Vancouver General Hospital,
significant improvements in rates of major complications,
including transfusion rates and pulmonary complications as well as improvements in stone free status have been achieved
- Percutaneous Nephrolithotripsy is a safe and effective treatment for large calculi and those refractory to other treatment modalities
- A co-operative,
integrated relationship between the radiologist and urologist optimizes patient care and stone-free rates
- Complications can be minimized by strict adherence to basic anatomic priciples
Recommended in the Guidelines of the European Association of Urology for treatment of the following:
- large stones >2cm in size or >1.5cm for stones in a lower pole calyx
- staghorn calculi
- stones resistant to fragmentation by ESWL due to their composition e.g.
cystine,
calcium oxalate monohydrate
- stones that have proven refractory to ESWL or ureteroscopy
- congenital malformations with low probability of successful passage of stone fragments following ESWL e.g.
horseshoe kidney,
ectopic kidney,
calyceal diverticula
- patient obesity
- stones in obstructed systems that require simultaneous correction.
This includes cases of ureteropelvic junction obstruction with associated calculi,
where the patient can be rendered stone-free and undergo endopyelotomy with ureteric stenting as a single stage procedure with PNL