a novel single step percutaneous access sheath the initial human experience:一种新的单步经皮穿刺鞘的初步经验.pdfVIP
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a novel single step percutaneous access sheath the initial human experience:一种新的单步经皮穿刺鞘的初步经验
Urolithiasis/Endourology
A Novel Single Step Percutaneous
Access Sheath: The Initial Human Experience
D. Duane Baldwin,*,† Lincoln J. Maynes, Premal J. Desai, Forrest C. Jellison, Christopher K. Tsai
and Gary R. Barker
From the Division of Urology, Loma Linda University Medical Center, Loma Linda, California
Purpose: A novel 1-step percutaneous access sheath NS has been developed that allows the insertion of a dilating balloon
and renal access sheath in a single step. We present the initial human experience with this sheath.
Materials and Methods: We performed a retrospective chart and database review of the initial 30 consecutive patients
undergoing percutaneous nephrostolithotomy using the NS. Data collected included patient demographics, operative and
recovery parameters, and complications.
Results: Mean patient age was 50.4 years (range 11 to 81), mean body mass index was 31.63 kg/m2 (range 17.1 to 65) and
mean preoperative stone area was 6.23 cm2 (range 1 to 14.6). Six and 3 patients had full and partial staghorn calculi,
respectively. Access was achieved via the upper pole in 16 patients, middle pole in 7 and lower pole in 7. Mean operative time
was 114.8 minutes (range 61 to 237). Mean estimated blood loss was 145.5 cc (range 10 to 500) and mean postoperative
hospital stay was 4.89 days (range 2 to 14). A total of 23 patients (76.7%) had no residual calculi on postoperative
computerized tomography, 5 (16.7%) had residual fragments 4 mm or less and 2 (6.7%) had residual stone fragments greater
than 4 mm. There were no complications related to the NS.
Conclusions: The NS is safe, easy to use and has potential advantages compared to currently available renal access sheaths.
Key Words: kidney, kidney calculi, nephrostomy, percutaneous, balloon dilatation
here are 2 main dilation methods used in percutane-
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