Modified technique for difficult ureteral stenting in percutaneous nephrolithotomy via inferior calyx approach

Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy
Tie ZhouYinghao Sun

Abstract

Percutaneous nephrolithotomy (PCNL) via single inferior-calyceal tract is suitable for some partial staghorn calculi mainly located in the inferior calyx. A ureteral stent should be inserted at the end of PCNL to avoid urine leakage or ureteral obstruction by residual calculi. However, antegrade ureteral stenting via the inferior calyx is not always successful due to unfavorable lower pole calyx anatomy. In the present study, we introduced a modified method for difficult stenting. First a 0.038-inch zebra guidewire was retrogradely introduced through the previously inserted ureteral catheter and grasped out of the work sheath by a ureteroscopic forceps to develop a through-and-through guidewire; then an 8 Fr guide catheter was inserted antegradely over the guidewire into the ureter after removing the prior ureteral catheter; subsequently the zebra guidewire was removed and antegradely introduced into the bladder through the guide catheter, followed by antegrade insertion of a double J stent. Of 158 patients, 32 needed modified ureteral stenting; and the lower pole infundibulopelvic angle (LPIA) was measured in 25 patients with and in 57 patients without modified stenting. The results showed that LPIA in patients with modified s...Continue Reading

References

Jan 1, 1976·Scandinavian Journal of Urology and Nephrology·I Fernström, B Johansson
Mar 21, 2006·European Radiology·Klaus Armin Hausegger, Horst Rupert Portugaller
Nov 11, 2006·European Urology·Maurice Stephan MichelJens Jochen Rassweiler
Aug 19, 2008·European Urology·Jean J M C H de la RosetteGlenn M Preminger

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