TY - JOUR
T1 - European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Percutaneous Nephrolithotomy
AU - Zeng, Guohua
AU - Zhong, Wen
AU - Pearle, Margaret
AU - Choong, Simon
AU - Chew, Ben
AU - Skolarikos, Andreas
AU - Liatsikos, Evangelos
AU - Pal, Shashi Kiran
AU - Lahme, Sven
AU - Durutovic, Otas
AU - Farahat, Yasser
AU - Khadgi, Sanjay
AU - Desai, Mahesh
AU - Chi, Thomas
AU - Smith, Daron
AU - Hoznek, Andras
AU - Papatsoris, Athanasios
AU - Desai, Janak
AU - Mazzon, Giorgio
AU - Somani, Bhaskar
AU - Eisner, Brian
AU - Scoffone, Cesare Marco
AU - Nguyen, Dong
AU - Ferretti, Stefania
AU - Giusti, Guido
AU - Saltirov, Iliya
AU - Maroccolo, Marcus Vinicius
AU - Gökce, Mehmet Ilker
AU - Straub, Michael
AU - Bernardo, Norberto
AU - Lantin, Pedro Laki
AU - Saulat, Sherjeel
AU - Gamal, Wael
AU - Denstedt, John
AU - Ye, Zhangqun
AU - Sarica, Kemal
N1 - Publisher Copyright:
© 2021
PY - 2022/3
Y1 - 2022/3
N2 - Context: Although percutaneous nephrolithotomy (PCNL) has been performed for decades and has gone through many refinements, there are still concerns regarding its more widespread utilization because of the long learning curve and the potential risk of severe complications. Many technical details are not included in the guidelines because of their nature and research protocol. Objective: To achieve an expert consensus viewpoint on PCNL indications, preoperative patient preparation, surgical strategy, management and prevention of severe complications, postoperative management, and follow-up. Evidence acquisition: An international panel of experts from the Urolithiasis Section of the European Association of Urology, International Alliance of Urolithiasis, and other urology associations was enrolled, and a prospectively conducted study, incorporating literature review, discussion on research gaps (RGs), and questionnaires and following data analysis, was performed to reach a consensus on PCNL. Evidence synthesis: The expert panel consisted of 36 specialists in PCNL from 20 countries all around the world. A consensus on PCNL was developed. The expert panel was not as large as expected, and the discussion on RGs did not bring in more supportive evidence in the present consensus. Conclusions: Adequate preoperative preparation, especially elimination of urinary tract infection prior to PCNL, accurate puncture with guidance of fluoroscopy and/or ultrasonography or a combination, keeping a low intrarenal pressure, and shortening of operation time during PCNL are important technical requirements to ensure safety and efficiency in PCNL. Patient summary: Percutaneous nephrolithotomy (PCNL) has been a well-established procedure for the management of upper urinary tract stones. However, according to an expert panel consensus, core technical aspects, as well as the urologist's experience, are critical to the safety and effectiveness of PCNL.
AB - Context: Although percutaneous nephrolithotomy (PCNL) has been performed for decades and has gone through many refinements, there are still concerns regarding its more widespread utilization because of the long learning curve and the potential risk of severe complications. Many technical details are not included in the guidelines because of their nature and research protocol. Objective: To achieve an expert consensus viewpoint on PCNL indications, preoperative patient preparation, surgical strategy, management and prevention of severe complications, postoperative management, and follow-up. Evidence acquisition: An international panel of experts from the Urolithiasis Section of the European Association of Urology, International Alliance of Urolithiasis, and other urology associations was enrolled, and a prospectively conducted study, incorporating literature review, discussion on research gaps (RGs), and questionnaires and following data analysis, was performed to reach a consensus on PCNL. Evidence synthesis: The expert panel consisted of 36 specialists in PCNL from 20 countries all around the world. A consensus on PCNL was developed. The expert panel was not as large as expected, and the discussion on RGs did not bring in more supportive evidence in the present consensus. Conclusions: Adequate preoperative preparation, especially elimination of urinary tract infection prior to PCNL, accurate puncture with guidance of fluoroscopy and/or ultrasonography or a combination, keeping a low intrarenal pressure, and shortening of operation time during PCNL are important technical requirements to ensure safety and efficiency in PCNL. Patient summary: Percutaneous nephrolithotomy (PCNL) has been a well-established procedure for the management of upper urinary tract stones. However, according to an expert panel consensus, core technical aspects, as well as the urologist's experience, are critical to the safety and effectiveness of PCNL.
KW - Expert consensus
KW - PCNL
KW - Percutaneous nephrolithotomy
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U2 - 10.1016/j.euf.2021.03.008
DO - 10.1016/j.euf.2021.03.008
M3 - Review article
C2 - 33741299
AN - SCOPUS:85102846325
SN - 2405-4569
VL - 8
SP - 588
EP - 597
JO - European Urology Focus
JF - European Urology Focus
IS - 2
ER -