TY - JOUR

T1 - Evaluation of the effect of bernoulli maneuver on operative time during mini-percutaneous nephrolithotomy

T2 - A prospective randomized study

AU - Gadzhiev, Nariman

AU - Sergei, Brovkin

AU - Grigoryev, Vladislav

AU - Okhunov, Zhamshid

AU - Ganpule, Arvind

AU - Pisarev, Aleksei

AU - Iskakov, Yerbol

AU - Petrov, Sergei

N1 - Publisher Copyright: © The Korean Urological Association, 2017.

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Bernoulli

KW - Nephrolithiasis

KW - Percutaneous nephrolithotomy

KW - Renal stone

UR - http://www.scopus.com/inward/record.url?scp=85018971581&partnerID=8YFLogxK

U2 - 10.4111/icu.2017.58.3.179

DO - 10.4111/icu.2017.58.3.179

M3 - Article

C2 - 28480343

AN - SCOPUS:85018971581

VL - 58

SP - 179

EP - 185

JO - Investigative and Clinical Urology

JF - Investigative and Clinical Urology

SN - 2466-0493

IS - 3

ER -