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Second-look nephroscopy after percutaneous nephrolithotomy

By Bodo E. Knudsen

Abstract

Percutaneous nephrolithotomy (PCNL) is the standard of care for the management of large renal stone burdens. Residual stones after PCNL may be cleared with a second-look nephroscopy. Determining whether a patient should undergo a second-look procedure is based on both the intraoperative findings and the post-operative imaging. Aggressive intraoperative flexible nephroscopy, may reduce the need for routine second-look nephroscopy. Post-operative computed tomograpahy (CT) imaging is the most sensitive method for detecting residual stone fragments. When a clinically significant residual stone burden exists a second-look procedure may be performed in an effort to render the patient stone-free. In most instances the procedure can be performed in an ambulatory facility under conscious intravenous sedation. Future prospective study determining the threshold of fragment size after PCNL that warrants second-look nephroscopy is needed

Topics: Reviews
Publisher: SAGE Publications
OAI identifier: oai:pubmedcentral.nih.gov:3126048
Provided by: PubMed Central
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