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International Alliance of Urolithiasis(IAU)consensus on miniaturized percutaneous nephrolithotomy

摘要Over the past three decades,there has been increasing interest in miniaturized percutaneous nephrolithotomy(mPCNL)techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL(sPCNL).However,despite this growing acceptance and recognition of its benefits,unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks.In response to these challenges,an international panel comprising experts from the International Alliance of Urolithiasis(IAU)took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice.This endeavor involved conducting a systematic literature review to identify research gaps(RGs),which formed the foundation for developing a structured questionnaire survey.Subsequently,a two-round modified Delphi survey was implemented,culminating in a group meeting to generate final evidence-based comments.All 64 experts completed the second-round survey,resulting in a response rate of 100.0%.Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains,including general information(13 questions),preoperative work-up(13 questions),procedural tips and tricks(19 questions),and postoperative evaluation and follow-up(13 questions).Additionally,9 questions evaluated the experts'experience with PCNLs.Consensus was reached on 30 questions after the second-round survey,while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting.mPCNL,characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique,has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics.It offers several advantages over sPCNL including reduced bleeding,fewer requirements for nephrostomy tubes,decreased pain,and shorter hospital stays.The series of detailed techniques presented here serve as a comprehensive guide for urologists,aiming to improve their procedural understanding and optimize patient outcomes.

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作者单位 Department of Urology and Guangdong Key Laboratory of Urology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510230,China [1] Department of Urology,San Bassiano Hospital,36061 Vicenza,Italy [2] Department of Urology,Siloah St.Trudpert Hospital,75179 Pforzheim,Germany [3] Department of Urology,Vayodha Hospital,Kathmandu 44600,Nepal [4] Department of Urology,Muljibhai Patel Urological Hospital,Nadiad 387001,India [5] Department of Urology,Centre for Minimally-Invasive Endourology,Global Rainbow Healthcare,Agra 282007,India [6] Department of Urology,Stony Brook University School of Medicine,Stony Brook,NY 11794,USA [7] Department of Urology,Icahn School of Medicine at Mount Sinai,Mount Sinai Health System,New York,NY 10029,USA [8] Department of Urology,Fondazione IRCSS Ca'Granda,Ospedale Maggiore Policlinico,University of Milan,20122 Milan,Italy [9] Department of Urology,Barcelona Clinical Hospital,08036 Barcelona,Spain [10] Department of Urology,Sabah Al Ahmad Urology Centre,20005 Kuwait,Kuwait [11] Department of Surgery,Section of Urology,Veterans Memorial Medical Center,1110 Quezon City,Metro Manila,Philippines [12] Department of Urology,Darent Valley Hospital,Dartford DA2 8DA,UK [13] Department of Urology,University of Belgrade,11120 Belgrade,Serbia [14] Department of Urology,Stone and Endourology Unit,University College London Hospitals NHS Foundation Trust,London NW1 2BU,UK [15] Department of Urology,Hospital,University of Parma,43126 Parma,Italy [16] Department of Urology,King Fahd Hospital,23325 Jeddah,Saudi Arabia [17] Department of Urology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China [18] Department of Urology,Renmin Hospital of Wuhan University,Wuhan 430060,China [19] Department of Urology,Shanghai Changhai Hospital,Second Military Medical University,Shanghai 200433,China [20] Department of Urology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530022,China [21] Department of Urology,University Hospital Southampton NHS Trust,Southampton SO16 6YD,UK [22] Department of Urology,Hadassah Hebrew University Hospital,91120 Jerusalem,Israel [23] Department of Urology,Pantai Hospital,11900 Penang,Malaysia [24] Department of Urology,Vienna General Hospital,Medical University of Vienna,1090 Vienna,Austria [25] Department of Urology,Hospital de Clinicas Jose de San Martin,1120 Buenos Aires,Argentina [26] Department of Urology,Hamad Medical Corporation,2001 Doha,Qatar [27] Department of Urology,Jose R.Reyes Memorial Medical Center,1003 Manila,Philippines [28] Department of Nephrourology,Nagoya City University Graduate School of Medical Sciences,Nagoya 464-0083,Japan [29] Department of Urology,San Luigi Gonzaga Hospital,University of Turin,10043 Orbassano,Turin,Italy [30] Department of Urology,Klinikum Sindelfingen-Boeblingen,University of Tuebingen,71032 Tuebingen,Germany [31] Department of Urology,Sismanogleion General Hospital,School of Medicine,National and Kapodistrian University of Athens,15126 Athens,Greece [32] Department of Urology,Saint-Petersburg State University Hospital,Saint-Petersburg,Russia 194100 [33] Department of Urology and Andrology,Astana Medical University,010000 Astana,Kazakhstan [34] Department of Urology,Puigvert Foundation,Autonomous University of Barcelona,08025 Barcelona,Spain [35] Department of Urology,San Ignacio University Hospital,110231 Bogotá,Colombia [36] Department of Urology and Nephrology,Military Medical Academy,1431 Sofia,Bulgaria [37] Department of Urology,Al Zahraa Hospital University Medical Center and Lebanese University,Beirut 10001,Lebanon [38] Department of Urology,IRCCS San Raffaele Hospital,Ville Turro Division,20127 Milan,Italy [39] Department of Urology,Endourology and Stone Disease Section,University of Sao Paulo Medical School,Sao Paulo 05508,Brazil [40] Department of Urology,Specialty Hospital La Raza,National Medical Center of the Mexican Institute of Social Security,97217 Mexico City,Mexico [41] Department of Urology,UT Southwestern Medical Center,Dallas,TX 75390,USA [42] Division of Urologic Surgery,Duke University Medical Center,Durham,NC 27705,USA [43] Department of Urology,National University Hospital,Singapore 119074,Singapore [44] Urology Unit,Department of Surgery,University Malaya Medical Center,50603 Kuala Lumpur,Malaysia [45] Department of Urology,Division of Endourology,University of Michigan,Ann Arbor,MI 48109,USA [46] Department of Urology,Hospital de Base of the Federal District,Brasília 70330-150,Brazil [47] Department of Urology,Karolinska University Stockholm Sweden and Aarhus University Hospital,17176 Stockholm,Denmark [48] Department of Urology,Lillebaelt Hospital,University of Southern Denmark,246000 Vejle,Denmark [49] Department of Urology,St.Anna Hospital,05500 Piaseczno,Poland [50] Department of Urology,Akfa Medline Hospital,100211 Tashkent,Uzbekistan [51] Department of Urology,DOC University Clinic,760000 Bishkek,Kyrgyzstan [52] Department of Urology,Tajik State Medical University,734003 Dushanbe,Tajikistan [53] Department of Urology,Tte.Ettiene 215,110309 Fernando de La Mora,Paraguay [54] Department of Urology,Aria Apollo Hospital,Ameriat Square,3001 Herat,Afghanistan [55] Department of Urology,Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico,University of Milan,28-20122 Milan,Italy [56] Department of Surgery,Nepal Medical College Teaching Hospital,Jorpati,Kathmandu 44600,Nepal [57] Department of Urology,Istanbul Medipol University,Istanbul 34815,Turkey [58] Department of Surgery,Division of Urology,Schulich School of Medicine and Dentistry,Western University,London,ON N6A 5C1,Canada [59] Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430074,China [60] Department of Urology,Medical School,Biruni University,Istanbul 34020,Turkey [61] Department of Urology,University College Hospital of London,London NW1 2BU,UK [62]
DOI 10.1186/s40779-024-00562-3
发布时间 2025-09-02(万方平台首次上网日期,不代表论文的发表时间)
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军事医学研究(英文版)

军事医学研究(英文版)

2025年12卷7期

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