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Comparison of renal parenchymal trauma after standard, mini and ultra-mini percutaneous tract dilation in porcine models

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Abstract

Objective

To evaluate whether reducing tract dilation diameter in PCNL (percutaneous nephrolithotomy) procedures results in minimizing of renal trauma of the percutaneous tract.

Methods

A percutaneous renal access tract was established bilaterally to 11 pigs. Two pigs were euthanized immediately after the experiment, while nine pigs were sacrificed 1 month later. The percutaneous accesses were dilated up to 30Fr, 22Fr or 12Fr. The animals underwent a contrast-enhanced computer tomography immediately after the procedure and 30 days later. DMSA-scintigraphy with SPECT-CT was also performed. The kidneys of all animals were harvested for histological evaluation. The volume of scar tissue and the percentage of renal volume replaced by scar tissue were calculated.

Results

Immediate post-procedural CT-scans revealed a significant difference in defect diameter among the three modalities. However, the scar volume calculated on CT-images and histopathology showed a significant difference only when 30Fr dilation was compared to 12Fr dilation. The percentage of scar volume was negligible in all cases, but there was still a statistical difference between 30 and 12Fr dilation. Dilation up to 22Fr revealed no statistical differences compared to the other two modalities. DMSA-scintigraphy showed no scar tissue in any case.

Conclusion

Dilation up to 30Fr may cause a significantly larger scar tissue on renal parenchyma compared to 12Fr dilation as it was shown on CT-images and microscopic evaluation, but based on the DMSA/SPECT-CT this difference seems to be insignificant to the renal function. The scar tissue caused by 22Fr dilation seemed to have no significant difference from the other modalities.

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Acknowledgements

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Author information

Authors and Affiliations

  1. Department of Urology, University Hospital of Patras, Patras, Greece

    Constantinos Adamou, Arman Tsaturyan, Konstantinos Pagonis, Angelis Peteinaris, Evangelos Liatsikos & Panagiotis Kallidonis

  2. Department of Radiology, University Hospital of Patras, Patras, Greece

    Christina Kalogeropoulou

  3. Department of Pathology, University Hospital of Patras, Patras, Greece

    Vasiliki Tzelepi

  4. Department of Nuclear Medicine, University Hospital of Patras, Patras, Greece

    Dimitris Apostolopoulos

  5. Department of Anesthesiology and Intensive Care, University Hospital of Patras, Patras, Greece

    Theofanis Vretos

  6. Department of Urology, Medical University of Vienna, Vienna, Austria

    Evangelos Liatsikos

  7. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia

    Evangelos Liatsikos

Authors
  1. Constantinos Adamou
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  2. Arman Tsaturyan
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  3. Christina Kalogeropoulou
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  4. Vasiliki Tzelepi
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  5. Dimitris Apostolopoulos
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  6. Theofanis Vretos
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  7. Konstantinos Pagonis
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  8. Angelis Peteinaris
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  9. Evangelos Liatsikos
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  10. Panagiotis Kallidonis
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Contributions

CA: protocol/project development, data collection or management, data analysis, manuscript writing/editing. AT: data collection or management, manuscript writing/editing. CK: data analysis. VT: data analysis. DA: data analysis. TV: data collection or management. KP: data collection or management. AP: data collection or management. EL: protocol/project development, manuscript writing/editing. PK: protocol/project development, manuscript writing/editing.

Corresponding author

Correspondence to Constantinos Adamou.

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The authors declare no conflict of interest.

Ethical approval

The responsible Veterinary Service of the State provided approval for conducting the experiment (No: 6447/2, 16/01/2018).

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Adamou, C., Tsaturyan, A., Kalogeropoulou, C. et al. Comparison of renal parenchymal trauma after standard, mini and ultra-mini percutaneous tract dilation in porcine models. World J Urol 40, 2083–2089 (2022). https://doi.org/10.1007/s00345-022-04069-1

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  • DOI: https://doi.org/10.1007/s00345-022-04069-1

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