KMID : 1011820170580030179
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Investigative and Clinical Urology 2017 Volume.58 No. 3 p.179 ~ p.185
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Evaluation of the effect of Bernoulli maneuver on operative time during mini-percutaneous nephrolithotomy: A prospective randomized study
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Gadzhiev Nariman
Sergei Brovkin Grigoryev Vladislav Okhunov Zhamshid Ganpule Arvind Pisarev Aleksei Iskakov Yerbol Petrov Sergei
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Abstract
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Purpose: To evaluate the effect of ¡®Bernoulli maneuver¡¯ (bringing the access sheath to horizontal plane) on operative time and stone free rates in patients undergoing mini-percutaneous nephrolithotomy (PCNL).
Materials and Methods: All consecutive patients with a solitary kidney stone undergoing a mini-PCNL between 2015 and 2016 were included into this study. Patients were randomized either to standard prone or control (C) group patients or to tilted prone with ¡®Bernoulli maneuver¡¯ group (B) patients. Pre-, intra-, and postoperative characteristics of these 2 groups were recorded and analyzed.
Results: A total of 67 patients were included in the study. Of these, 40 patients were randomized to group C and 27 to group B. The mean (95% confidence limits) stone size (mm) in group C and B was 14 (13, 15) and 13 (11, 14), respectively (p=0.26). Nephroscopy time was shorter in Bernoulli group (35 minutes vs. 23 minutes, p=1.5¡¤10-5, and Bayes factor BF10=2,340, and Cohen standardized effect size dst=1.2). The difference made it up 12 minutes (with 95% confidence interval from 8 to 18 minutes). There were no statistically significant differences between groups regarding white blood cell, creatinine level and stone-free status defined by computed tomography on the first postoperative day.
Conclusions: In our study the ¡®Bernoulli maneuver¡¯ led to a shorter nephroscopy time in mini-PCNL. This maneuver can significantly reduce nephroscopy time and save significant amount of operative time, especially in tertiary referral centers with high-volume mini-PCNL procedures.
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KEYWORD
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Bernoulli, Nephrolithiasis, Percutaneous nephrolithotomy, Renal stone
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