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Septic Complications During Percutaneous Nephrolithotomy (PCNL)

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Abstract

Percutaneous nephrolithotomy (PCNL) is a milestone for the removal of renal stones for three decades already. Since the first introduction of the technique in 1976, various improvements have been proposed. The indications of the procedure were limited due to the introduction of extracorporeal shock wave lithotripsy (ESWL) in the 1980s. Clinical experience with ESWL revealed the limitations of the technique, and the role of PCNL in the management of renal stones was redefined. The current indications for PCNL include large, hard infected stones, obstruction-related stones, ESWL failures, and stones related with anatomical variations. In addition, improvements in instruments such as flexible nephroscopes, ureteroscopes, and lithotriptors (holmium/yttrium-aluminum-garnet laser, combination of ultrasound and pneumatic technology) contributed to the current high stone-free rates of PCNL which are higher than 90 %. Flexible nephroscopes allowed the disintegration and removal of stones in calyces not accessible by the rigid nephroscopes, while advanced lithotriptors enabled the management of very hard stones.

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Authors and Affiliations

  1. Department of Urology, University Hospital of Patras, Rion, Patras, 26504, Greece

    Evangelos Liatsikos M.D., Ph.D. & Panagiotis Kallidonis M.D.

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  1. Evangelos Liatsikos M.D., Ph.D.
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  2. Panagiotis Kallidonis M.D.
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Correspondence to Panagiotis Kallidonis M.D. .

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Editors and Affiliations

  1. Fac. Medicine, Dept. Surgery, Kuwait University, Safat, Kuwait

    Ahmed M. Al-Kandari

  2. , Department of Urology, Muljibhai Patel Urological Hospital, Dr Virendra Desai Road, Nadiad, 387 001, India

    Mahesh Desai

  3. , Urology and Nephrology Center, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt

    Ahmed A. Shokeir

  4. , Urology and Nephrology Center, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt

    Ahmed M. Shoma

  5. , Smith Institute for Urology, Long Island Jewish Health System, New York, 11040, USA

    Arthur D. Smith

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Liatsikos, E., Kallidonis, P. (2013). Septic Complications During Percutaneous Nephrolithotomy (PCNL). In: Al-Kandari, A., Desai, M., Shokeir, A., Shoma, A., Smith, A. (eds) Difficult Cases in Endourology. Springer, London. https://doi.org/10.1007/978-1-84882-083-8_6

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  • DOI: https://doi.org/10.1007/978-1-84882-083-8_6

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  • Online ISBN: 978-1-84882-083-8

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