Micronefrolitotomia Percutânea: Descrição de uma Variante da Técnica Original
DOI:
https://doi.org/10.24915/aup.34.3-4.63Palavras-chave:
Nefrostomia Percutânea, Cálculos Renais/cirurgiaResumo
A micronefrolitotomia percutânea (microperc) é o avanço tecnológico mais recente no tratamento da litíase renal. Descrevemos uma variação da técnica original e as vantagens adicionais que confere a esta abordagem cirúrgica. Uma mulher de 67 anos, com um índice de massa corporal de 28,6 kg/m2 e um cálculo de 25 x 20 mm do bacinete esquerdo foi colocada em posição de Valdivia modificada segundo Galdakao. Após pielografia ascendente foi colocada uma bainha ureteral 11/13 F ao nível da junção pieloureteral. A punção renal foi efetuada sob controlo fluoroscópico. O cálculo foi desintegrado com laser holmium. No final do procedimento procedeu-se à inspeção do sistema coletor com ureterorrenoscópio flexível para comprovar a ausência de fragmentos residuais.
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Referências
1. Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD. Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol. 2012; 188: 247–52.
2. Marickar YM, Vijay A. Female stone disease: the changing trend. Urol Res. 2009; 37: 337–40.
3. Türk C, Knoll T, Petrik A. European Association of Urology Guidelines on Urolithiasis. Uroweb 2012. [accessed Jan 2017] Available from: http://www.uroweb.org/gls/pdf/20_
4. Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.
Cochrane Database Syst Rev. 2014;11:CD007044.
5. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol. 2005; 51: 899–906.
6. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 2004; 18: 715–22.
7. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol. 2011; 186: 140–5.
8. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M. The ‘all-seeing needle’: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol. 2011; 59: 1054–9.
9. Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR. Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled
trial; BJU Int. 2013; 112:355-61.
10. Tepeler A, Armagan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol. 2013; 27:13–8.
11. Bagcioglu M, Demir A, Sulhan H, Karadag MA, Uslu M, Tekdogan UY. Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures. Urolithiasis.
2016; 44:339-44. d
12. Armagan A, Tepeler A, Silay MS, Ersoz C, Akcay M, Akman T, et al. Micropercutaneous nephrolithotomy in the treatment of moderate-size renal calculi. J Endourol. 2013; 27:177–81.
13. Armagan A, Karatag T, Buldu I. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones. World J Urol. 2015; 33:1827–31.
14. Tepeler A, Akman T, Silay MS, Akcay M, Ersoz C, Kalkan S, et al. Comparison of intrarenal pelvic pressure during micropercutaneous nephrolithotomy and conventional percutaneous nephrolithotomy. Urolithiasis. 2014;
42:275-9.
15. Akbulut F, Ucpinar B, Savun M, Kucuktopcu O, Ozgor F, Simsek A, et al. A major complication in micropercutaneous nephrolithotomy: upper calyceal perforation with extrarenal migration of stone fragments due to increased intrarenal pelvic pressure. Case Rep Urol. 2015:792780.
16. Guohua Z, Wen Z, Xun l, Wenzhong C, Yongzhong H, Zhaohui H, et al. The influence of minimally invasive percutaneous nephrolithotomy on renal pelvic pressure in vivo. Surg Laparosc Endosc Percutan Tech. 2007:
17:307– 10.
17. Troxel SA, Low RK. Renal intrapelvic pressure during percutaneous nephrolithotomy and its correlation with the development of postoperative fever. J Urol. 2002: 168:1348–51.
18. Penbegul N, Bodakci MN, Hatipoglu NK, Sancaktutar AA, Atar M, Cakmakci S, et al. Microsheath for microperc: 14-gauge angiocath. J Endourol. 2013; 27:835-9.
2. Marickar YM, Vijay A. Female stone disease: the changing trend. Urol Res. 2009; 37: 337–40.
3. Türk C, Knoll T, Petrik A. European Association of Urology Guidelines on Urolithiasis. Uroweb 2012. [accessed Jan 2017] Available from: http://www.uroweb.org/gls/pdf/20_
4. Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.
Cochrane Database Syst Rev. 2014;11:CD007044.
5. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol. 2005; 51: 899–906.
6. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 2004; 18: 715–22.
7. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol. 2011; 186: 140–5.
8. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M. The ‘all-seeing needle’: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol. 2011; 59: 1054–9.
9. Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR. Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled
trial; BJU Int. 2013; 112:355-61.
10. Tepeler A, Armagan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol. 2013; 27:13–8.
11. Bagcioglu M, Demir A, Sulhan H, Karadag MA, Uslu M, Tekdogan UY. Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures. Urolithiasis.
2016; 44:339-44. d
12. Armagan A, Tepeler A, Silay MS, Ersoz C, Akcay M, Akman T, et al. Micropercutaneous nephrolithotomy in the treatment of moderate-size renal calculi. J Endourol. 2013; 27:177–81.
13. Armagan A, Karatag T, Buldu I. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones. World J Urol. 2015; 33:1827–31.
14. Tepeler A, Akman T, Silay MS, Akcay M, Ersoz C, Kalkan S, et al. Comparison of intrarenal pelvic pressure during micropercutaneous nephrolithotomy and conventional percutaneous nephrolithotomy. Urolithiasis. 2014;
42:275-9.
15. Akbulut F, Ucpinar B, Savun M, Kucuktopcu O, Ozgor F, Simsek A, et al. A major complication in micropercutaneous nephrolithotomy: upper calyceal perforation with extrarenal migration of stone fragments due to increased intrarenal pelvic pressure. Case Rep Urol. 2015:792780.
16. Guohua Z, Wen Z, Xun l, Wenzhong C, Yongzhong H, Zhaohui H, et al. The influence of minimally invasive percutaneous nephrolithotomy on renal pelvic pressure in vivo. Surg Laparosc Endosc Percutan Tech. 2007:
17:307– 10.
17. Troxel SA, Low RK. Renal intrapelvic pressure during percutaneous nephrolithotomy and its correlation with the development of postoperative fever. J Urol. 2002: 168:1348–51.
18. Penbegul N, Bodakci MN, Hatipoglu NK, Sancaktutar AA, Atar M, Cakmakci S, et al. Microsheath for microperc: 14-gauge angiocath. J Endourol. 2013; 27:835-9.
Publicado
2017-12-17
Edição
Secção
Case Report
