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Exploring the Effectiveness of D-mPCNL in Treating Large Kidney Stones

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Medriva Correspondents
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Exploring the Effectiveness of D-mPCNL in Treating Large Kidney Stones

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In recent years, modern medicine has made significant strides in developing innovative and effective treatments for various health conditions. One such advancement is the use of minimally invasive percutaneous nephrolithotomy (MPCNL) techniques for treating large kidney stones. Most notable among these is the double-sheath negative-pressure technique, also known as D-mPCNL. Several studies have been conducted to evaluate the effectiveness of this new method, with promising results.

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Understanding the D-mPCNL Technique

The D-mPCNL technique involves the use of two sheaths to create negative pressure. This innovative approach aids in fragmenting and removing large kidney stones more effectively. According to a study conducted by the Zhongnan Hospital of Wuhan University, the D-mPCNL method has several advantages over the conventional MPCNL (C-mPCNL) technique. The study included 132 patients with significant renal calculi and used preoperative imaging to determine stone size and location. All operations in the study were performed by skilled surgeons.

Benefits of D-mPCNL Over C-mPCNL

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A comparative study found that D-mPCNL had a significantly shorter operative time, lower rates of auxiliary procedures, and lower fever rates compared to the conventional method. Additionally, the D-mPCNL group had a significantly higher primary stone-free rate. However, there were no statistically significant advantages in terms of the final stone-free rate, hemoglobin drops, and stone composition in the D-mPCNL group.

Despite these factors, the study concludes that D-mPCNL is a novel surgical method that is safe and effective. It reduces operative time, improves stone-free efficiency, and decreases postoperative complications. This makes it a viable treatment option for large kidney stones.

Advancements in Assessing Intrapelvic Pressure

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Another noteworthy development in this field is the use of an ultra-miniature fiber optic pressure sensor for assessing intrapelvic pressure (IPP) during flexible ureteroscopy (f URS). A study successfully developed an automatic regulation system for maintaining safe IPP levels, marking a significant milestone in the field.

Predicting Outcomes with Mini Endoscopic Combined IntraRenal Surgery (ECIRS)

Researchers have also been working on developing models to predict the outcomes of mini endoscopic combined intrarenal surgery (ECIRS) in patients with renal and/or ureteral stones. A study analyzed data from 1432 ECIRS procedures and found that the overall stone-free (SF) rate was 62.3%. They developed three prediction models, including multiple logistic regression, classification tree analysis, and machine learning-based random forest. The study concluded that their proposed prediction model would lead to a safer and more efficient treatment strategy with mini ECIRS.

The advancements in this field represent a significant step towards improving patient outcomes in the treatment of large kidney stones. While conventional methods remain effective, the introduction of techniques such as D-mPCNL and the development of predictive models for ECIRS procedures offer promising alternatives that could revolutionize kidney stone treatment in the future.

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