Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure considered as the treatment of choice for the management of large-scale and fully-formed kidney stones.This procedure has a 5% risk of complications including bleeding, the lesion of the collecting system, the risk of urinary infection and bacteremia. New surgical tools such as dilatation of the nephrostomy tract with mechanical dilatation contribute to the reduction of these risks, together with an improvement in the operative times and a lower rate of complications.
At present there are multiple scales measuring the lithiasic morphology (Guy, the STONE nephrolitometry score system and the nomogram of the Office of Clinical Investigation of the Endourology Society - CROES) which allow to evaluate the degree of complexity of the stone, the possibility of residual stones and the risk of complications. These tools allow us to do a better analysis of the risk factors of the patient who will be taken to this type of endoscopic procedure in order to decrease morbidity and complication rates.
Hypothesis:
The use of pneumatic dilators during percutaneous nephrolithotomy reduces the rates of intraoperative and postoperative complications, which would have an impact on hospitalization times and surgical success for the management of renal stone.

Start Date10 May 2017

Sponsor / Collaborator

Los Comuneros Hospital Universitario de Bucaramanga SA

100 Clinical Results associated with Los Comuneros Hospital Universitario de Bucaramanga SA

0 Patents (Medical) associated with Los Comuneros Hospital Universitario de Bucaramanga SA

Literatures (Medical) associated with Los Comuneros Hospital Universitario de Bucaramanga SA

01 Sep 2023·EuroIntervention

Clinical outcomes of TAVI with the Myval balloon-expandable valve for non-calcified aortic regurgitation

Article

Author: Sanchez-Luna, Juan Pablo ; Gonzalez-Gutiérrez, Jose Carlos ; Mussayev, Abdurashid ; Dager, Antonio E ; Giannini, Francesco ; Stepanenko, Alexander ; Monastyrski, Andrea ; Ancona, Marco Bruno ; Gómez, Javier ; Fernandez-Avilés, Francisco ; Gomez-Salvador, Itziar ; Ortiz, Miguel ; Gómez-Menchero, Antonio ; San Román, J Alberto ; De Brahi, Juan Pablo ; Martín, Pedro ; García Puerta, Melissa ; Amat-Santos, Ignacio J ; Gonzalez-Bartol, Esther ; Charry, Pablo D ; Pan, Manuel ; Lamelas, Pablo ; Sánchez-Recalde, Ángel ; Sánchez-Pérez, Andrés ; Marengo, Giorgio ; Beltrán, Javier R ; Ielasi, Alfonso ; Barbanti, Marco

BACKGROUNDTranscatheter aortic valve replacement (TAVR) in non-calcified aortic regurgitation (NCAR) is an off-label procedure. The balloon-expandable Myval includes extra-large sizes (30.5 mm and 32 mm) of interest in this setting.AIMSWe aimed to evaluate the safety and feasibility of Myval in NCAR.METHODSThis was an international, multicentre, observational study that enrolled all consecutive patients with symptomatic severe NCAR undergoing TAVR with the Myval device. The images were centrally analysed.RESULTSA total of 113 patients were recruited, 64.6% were men, the mean age was 78.4±7.5 years, and the Society of Thoracic Surgeons score was 2.7±1.7%. Aortic root dilatation was present in 59.3% of patients, 7.1% were bicuspid, and the mean annular area was 638.6±106.0 mm². The annular area was beyond the recommended range for extra-large sizes in 2.6% of cases, and additional volume was added in 92% (median 4 cc, up to 9 cc). The extra-large sizes were used in 95 patients (84.1%), and the mean oversizing was 17.9±11.0%. The technical success rate was 94.7%; the rate of residual ≥moderate aortic regurgitation was 8.9%, and the pacemaker rate was 22.2%. There were no cases of annular rupture, cardiac tamponade, or aortic dissection, but in 4 patients (3.5%) valve embolisation occurred (1 antegrade and 3 ventricular), all in cases with a tapered left ventricle outflow tract (p=0.007). Thirty-day and 1-year mortality were 5.3% and 9.7%, respectively. Technical success was associated with better survival (97.1% vs 72.7%; p=0.012), and valve embolisation was the main determinant of mortality (p=0.047).CONCLUSIONSMyval is a feasible and safe option for selected non-operable patients with NCAR and demonstrated good midterm outcomes and lack of impact of oversizing on device durability.

01 Nov 2017·Urology Case Reports

Percutaneous Nephrolithotomy, Ileal Conduit- Lithotripsy and Litholapaxy for a Neglected Encrusted Ureteral Stent

Author: Chavarriaga, Julián ; Hernandez, Carlos ; Gutierrez, Andrés ; Ocampo, María A

Urolithiasis can result as a complication of urinary diversión, favored by urinary stasis, intestinal mucus, urinary tract bacteriuria, the metabolic derangements and the presence of foreign bodies. We present a 52- year-old male who underwent radical cystectomy with construction of a Bricker uretero-ileostomy. 5 years later he was found with a forgotten ureteral stent, a 6 cm calculi occupying the whole ileal conduit and a 13 mm calculi in the left renal pelvis. We present our experience in the successful endourological management of an encrusted neglected ureteral stent in an ileal conduit, achieving a stone-free status without complications.

Revista da Escola de Enfermagem da USPQ4 · MEDICINE

Nursing intervention to prevent delirium in critically ill adults

Q4 · MEDICINE

ArticleOA

Author: Castillo, Alfredo Hinestrosa Díaz del ; Contreras, Claudia Consuelo Torres ; Páez-Esteban, Astrid Nathalia ; Carvajal, Raquel Rivera ; Rincon-Romero, Mayerli Katherine ; Herrera, Marisela Márquez

ABSTRACT Objective: To determine the effectiveness of a nursing intervention for delirium prevention in critically ill patients. Method: A quasi-experimental study was conducted with a non-equivalent control group and with evaluation before and after the intervention. 157 Patients were part of the intervention group and 134 of the control group. Patients were followed-up until they were discharged from the ICU or died. The incidence of delirium in both groups was compared. Additionally, the effect measures were adjusted for the propensity score. Results: The incidence and incidence rate of delirium in the control group were 20.1% and 33.1 per 1000 person-days (CI 95% 22.7 to 48.3) and in the intervention group was 0.6% and 0.64 per 1000 person-days (CI 95% 0.22 to 11.09), respectively. The crude Hazard Ratio was 0.06 (CI 95% 0,008 to 0,45) and adjusted 0.07 (CI 95% 0,009 to 0,60). The number needed to be treated was six. Conclusion: Low incidence of delirium in critically ill patients intervened demonstrated the effectiveness of interventions. The average intervention time was 4 days with a 15-minutes dedication for each patient.

100 Deals associated with Los Comuneros Hospital Universitario de Bucaramanga SA

100 Translational Medicine associated with Los Comuneros Hospital Universitario de Bucaramanga SA

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