Outcome of Mini-PCNL Under Loco-Regional Anesthesia: Outcomes of a Systematic Review.

IF 2.5 2区医学 Q2 UROLOGY & NEPHROLOGY

Current Urology Reports Pub Date : 2023-09-01 DOI:10.1007/s11934-023-01169-2

Mohammed Shahait, Ala'a Farkouh, Philip Mucksavage, Bhaskar Somani

{"title":"Outcome of Mini-PCNL Under Loco-Regional Anesthesia: Outcomes of a Systematic Review.","authors":"Mohammed Shahait, Ala'a Farkouh, Philip Mucksavage, Bhaskar Somani","doi":"10.1007/s11934-023-01169-2","DOIUrl":null,"url":null,"abstract":"Purpose of review: Miniaturized PCNL (mi-PCNL) for stone disease is performed under a general anesthesia. However, the role of loco-regional anesthesia in mi-PCNL and its outcomes are not well defined yet. Here, we review the outcomes and complications of loco-regional anesthesia for mi-PCNL. A Cochrane-style review was performed in accordance with the preferred reporting items for systematic reviews to evaluate the outcomes of loco-reginal anesthesia for URS in stone disease, including all English language articles from January 1980 and October 2021.Recent findings: Ten studies with a total of 1663 patients underwent mi-PCNL under loco-regional anesthesia. The stone-free rate (SFR) for mi-PCNL under neuro-axial anesthesia ranged between 88.3 and 93.6%, while it ranged between 85.7 and 93.3% for mi-PCNL under local anesthesia (LA). The conversion rate to another anesthesia modality was 0.5%. The complications ranged widely between 3.3 and 85.7%. The majority were Grade I-II complications and none of the patients had grade V complications. Our review shows that mi-PCNL under loco-regional anesthesia is feasible with good SFR and a low risk of major complications. The conversion to general anesthesia is needed in a small minority, with the procedure itself being well tolerated and a big step towards establishing an ambulatory pathway for these patients.","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"24 9","pages":"417-426"},"PeriodicalIF":2.5000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Urology Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11934-023-01169-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: Miniaturized PCNL (mi-PCNL) for stone disease is performed under a general anesthesia. However, the role of loco-regional anesthesia in mi-PCNL and its outcomes are not well defined yet. Here, we review the outcomes and complications of loco-regional anesthesia for mi-PCNL. A Cochrane-style review was performed in accordance with the preferred reporting items for systematic reviews to evaluate the outcomes of loco-reginal anesthesia for URS in stone disease, including all English language articles from January 1980 and October 2021.

Recent findings: Ten studies with a total of 1663 patients underwent mi-PCNL under loco-regional anesthesia. The stone-free rate (SFR) for mi-PCNL under neuro-axial anesthesia ranged between 88.3 and 93.6%, while it ranged between 85.7 and 93.3% for mi-PCNL under local anesthesia (LA). The conversion rate to another anesthesia modality was 0.5%. The complications ranged widely between 3.3 and 85.7%. The majority were Grade I-II complications and none of the patients had grade V complications. Our review shows that mi-PCNL under loco-regional anesthesia is feasible with good SFR and a low risk of major complications. The conversion to general anesthesia is needed in a small minority, with the procedure itself being well tolerated and a big step towards establishing an ambulatory pathway for these patients.

Abstract Image

查看原文本刊更多论文

局部区域麻醉下Mini-PCNL的结果:一项系统评价的结果。

综述目的:在全身麻醉下进行结石性疾病的微型PCNL (mi-PCNL)。然而，局部区域麻醉在中度pcnl中的作用及其结果尚未明确。在这里，我们回顾局部区域麻醉治疗非pcnl的结果和并发症。按照首选的系统评价报告项目进行cochrane式评价，以评估局部区域麻醉治疗结石性尿路疾病的结果，包括1980年1月至2021年10月的所有英文文章。最近发现:10项研究共1663例患者在局部区域麻醉下进行了mi-PCNL。神经轴向麻醉下mi-PCNL的无结石率(SFR)在88.3 ~ 93.6%之间，而局部麻醉(LA)下mi-PCNL的无结石率在85.7 ~ 93.3%之间。另一种麻醉方式的转换率为0.5%。并发症发生率在3.3% ~ 85.7%之间。以I-II级并发症为主，无5级并发症。我们的综述表明，局部区域麻醉下的mi-PCNL具有良好的SFR和低的主要并发症风险，是可行的。少数患者需要转换为全身麻醉，手术本身耐受性良好，并且朝着为这些患者建立流动途径迈出了一大步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Urology Reports UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

3.80%

发文量

期刊介绍： This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.