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

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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.

Summary

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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Papers of particular interest, published within the annual period of review, have been highlighted as: • Of special interest • Of outstanding interest

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Acknowledgements

We thank Dr. Dana Weiss for reviewing the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Clemenceau Medical Center, Dubai, UAE

    Mohammed Shahait

  2. Department of Surgery, King Hussein Cancer Center, Amman, Jordan

    Ala’a Farkouh

  3. Department of Urology, Pennsylvania Hospital, Philadelphia, USA

    Philip Mucksavage

  4. Department of Urology, University Hospital Southampton, Southampton, UK

    Bhaskar Somani

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  1. Mohammed Shahait
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  2. Ala’a Farkouh
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  3. Philip Mucksavage
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  4. Bhaskar Somani
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Correspondence to Bhaskar Somani.

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Shahait, M., Farkouh, A., Mucksavage, P. et al. Outcome of Mini-PCNL Under Loco-Regional Anesthesia: Outcomes of a Systematic Review. Curr Urol Rep 24, 417–426 (2023). https://doi.org/10.1007/s11934-023-01169-2

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  • DOI: https://doi.org/10.1007/s11934-023-01169-2

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