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

Current Urology Reports - Tập 24 - Trang 417-426 - 2023
Mohammed Shahait1, Ala’a Farkouh2, Philip Mucksavage3, Bhaskar Somani4
1Department of Surgery, Clemenceau Medical Center, Dubai, UAE
2Department of Surgery, King Hussein Cancer Center, Amman, Jordan
3Department of Urology, Pennsylvania Hospital, Philadelphia, USA
4Department of Urology, University Hospital Southampton, Southampton, UK

Tóm tắt

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. 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.

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Current Urology Reports

Tập 24

417-426

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