International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Guo Hua Zeng; Wen Zhong; Giorgio Mazzon; Wei Zhu; Sven Lahme; Sanjay Khadgi; Janak Desai; Madhu Agrawal; David Schulsinger; Mantu Gupta; Emanuele Montanari; Juan Manuel Lopez Martinez; Shabir Almousawi; Vincent Emanuel F. Malonzo; Seshadri Sriprasad; Otas Durutovic; Vimoshan Arumuham; Stefania Ferretti; Wissam Kamal; Ke Wei Xu; Fan Cheng; Xiao Feng Gao; Ji Wen Cheng; Bhaskar Somani; Mordechai Duvdevani; Kah Ann Git; Christian Seitz; Norberto Bernardo; Tarek Ahmed Amin Ibrahim; Albert Aquino; Takahiro Yasui; Cristian Fiori; Thomas Knoll; Athanasios Papatsoris; Nariman Gadzhiev; Ulanbek Zhanbyrbekuly; Oriol Angerri; Hugo Lopez Ramos; Iliya Saltirov; Mohamad Moussa; Guido Giusti; Fabio Vicentini; Edgar Beltran Suarez; Margaret Pearle; Glenn M. Preminger; Qing Hui Wu; Khurshid Ghani; Marcus Maroccolo; Marianne Brehmer; Palle J. Osther; Marek Zawadzki; Azimdjon Tursunkulov; Monolov Nurbek Kytaibekovich; Abdusamad Abdukakhorovich Abuvohidov; Cesar Antonio Recalde Lara; Zamari Noori; Stefano Paolo Zanetti; Sunil Shrestha; Jean de la Rosette; John Denstedt; Zhang Qun Ye; Kemal Sarica; Simon Choong

doi:10.1186/s40779-024-00562-3

International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Guo Hua Zeng^*, Wen Zhong, Giorgio Mazzon, Wei Zhu, Sven Lahme, Sanjay Khadgi, Janak Desai, Madhu Agrawal, David Schulsinger, Mantu Gupta, Emanuele Montanari, Juan Manuel Lopez Martinez, Shabir Almousawi, Vincent Emanuel F. Malonzo, Seshadri Sriprasad, Otas Durutovic, Vimoshan Arumuham, Stefania Ferretti, Wissam Kamal, Ke Wei XuFan Cheng, Xiao Feng Gao, Ji Wen Cheng, Bhaskar Somani, Mordechai Duvdevani, Kah Ann Git, Christian Seitz, Norberto Bernardo, Tarek Ahmed Amin Ibrahim, Albert Aquino, Takahiro Yasui, Cristian Fiori, Thomas Knoll, Athanasios Papatsoris, Nariman Gadzhiev, Ulanbek Zhanbyrbekuly, Oriol Angerri, Hugo Lopez Ramos, Iliya Saltirov, Mohamad Moussa, Guido Giusti, Fabio Vicentini, Edgar Beltran Suarez, Margaret Pearle, Glenn M. Preminger, Qing Hui Wu, Khurshid Ghani, Marcus Maroccolo, Marianne Brehmer, Palle J. Osther, Marek Zawadzki, Azimdjon Tursunkulov, Monolov Nurbek Kytaibekovich, Abdusamad Abdukakhorovich Abuvohidov, Cesar Antonio Recalde Lara, Zamari Noori, Stefano Paolo Zanetti, Sunil Shrestha, Jean de la Rosette, John Denstedt, Zhang Qun Ye, Kemal Sarica, Simon Choong^*

^*Corresponding author for this work

Department of Clinical Medicine - Department of Urology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

1 Citation (Scopus)

Abstract

Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts’ experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

Original language	English
Article number	70
Journal	Military Medical Research
Volume	11
Issue	1
ISSN	2095-7467
DOIs	https://doi.org/10.1186/s40779-024-00562-3
Publication status	Published - Dec 2024

Keywords

Expert consensus
Kidney stone
Miniaturized PCNL (mPCNL)
Operation
Percutaneous nephrolithotomy (PCNL)

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10.1186/s40779-024-00562-3

Cite this

Zeng, G. H., Zhong, W., Mazzon, G., Zhu, W., Lahme, S., Khadgi, S., Desai, J., Agrawal, M., Schulsinger, D., Gupta, M., Montanari, E., Martinez, J. M. L., Almousawi, S., Malonzo, V. E. F., Sriprasad, S., Durutovic, O., Arumuham, V., Ferretti, S., Kamal, W., ... Choong, S. (2024). International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy. Military Medical Research, 11(1), Article 70. https://doi.org/10.1186/s40779-024-00562-3

@article{fb1c8f98e23b4369978f138a806b0d56,

title = "International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy",

abstract = "Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts{\textquoteright} experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.",

keywords = "Expert consensus, Kidney stone, Miniaturized PCNL (mPCNL), Operation, Percutaneous nephrolithotomy (PCNL)",

author = "Zeng, {Guo Hua} and Wen Zhong and Giorgio Mazzon and Wei Zhu and Sven Lahme and Sanjay Khadgi and Janak Desai and Madhu Agrawal and David Schulsinger and Mantu Gupta and Emanuele Montanari and Martinez, {Juan Manuel Lopez} and Shabir Almousawi and Malonzo, {Vincent Emanuel F.} and Seshadri Sriprasad and Otas Durutovic and Vimoshan Arumuham and Stefania Ferretti and Wissam Kamal and Xu, {Ke Wei} and Fan Cheng and Gao, {Xiao Feng} and Cheng, {Ji Wen} and Bhaskar Somani and Mordechai Duvdevani and Git, {Kah Ann} and Christian Seitz and Norberto Bernardo and Ibrahim, {Tarek Ahmed Amin} and Albert Aquino and Takahiro Yasui and Cristian Fiori and Thomas Knoll and Athanasios Papatsoris and Nariman Gadzhiev and Ulanbek Zhanbyrbekuly and Oriol Angerri and Ramos, {Hugo Lopez} and Iliya Saltirov and Mohamad Moussa and Guido Giusti and Fabio Vicentini and Suarez, {Edgar Beltran} and Margaret Pearle and Preminger, {Glenn M.} and Wu, {Qing Hui} and Khurshid Ghani and Marcus Maroccolo and Marianne Brehmer and Osther, {Palle J.} and Marek Zawadzki and Azimdjon Tursunkulov and Kytaibekovich, {Monolov Nurbek} and Abuvohidov, {Abdusamad Abdukakhorovich} and Lara, {Cesar Antonio Recalde} and Zamari Noori and Zanetti, {Stefano Paolo} and Sunil Shrestha and {de la Rosette}, Jean and John Denstedt and Ye, {Zhang Qun} and Kemal Sarica and Simon Choong",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

doi = "10.1186/s40779-024-00562-3",

language = "English",

volume = "11",

journal = "Military Medical Research",

issn = "2095-7467",

publisher = "BioMed Central",

number = "1",

}

Zeng, GH, Zhong, W, Mazzon, G, Zhu, W, Lahme, S, Khadgi, S, Desai, J, Agrawal, M, Schulsinger, D, Gupta, M, Montanari, E, Martinez, JML, Almousawi, S, Malonzo, VEF, Sriprasad, S, Durutovic, O, Arumuham, V, Ferretti, S, Kamal, W, Xu, KW, Cheng, F, Gao, XF, Cheng, JW, Somani, B, Duvdevani, M, Git, KA, Seitz, C, Bernardo, N, Ibrahim, TAA, Aquino, A, Yasui, T, Fiori, C, Knoll, T, Papatsoris, A, Gadzhiev, N, Zhanbyrbekuly, U, Angerri, O, Ramos, HL, Saltirov, I, Moussa, M, Giusti, G, Vicentini, F, Suarez, EB, Pearle, M, Preminger, GM, Wu, QH, Ghani, K, Maroccolo, M, Brehmer, M, Osther, PJ, Zawadzki, M, Tursunkulov, A, Kytaibekovich, MN, Abuvohidov, AA, Lara, CAR, Noori, Z, Zanetti, SP, Shrestha, S, de la Rosette, J, Denstedt, J, Ye, ZQ, Sarica, K & Choong, S 2024, 'International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy', Military Medical Research, vol. 11, no. 1, 70. https://doi.org/10.1186/s40779-024-00562-3

TY - JOUR

T1 - International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

AU - Zeng, Guo Hua

AU - Zhong, Wen

AU - Mazzon, Giorgio

AU - Zhu, Wei

AU - Lahme, Sven

AU - Khadgi, Sanjay

AU - Desai, Janak

AU - Agrawal, Madhu

AU - Schulsinger, David

AU - Gupta, Mantu

AU - Montanari, Emanuele

AU - Martinez, Juan Manuel Lopez

AU - Almousawi, Shabir

AU - Malonzo, Vincent Emanuel F.

AU - Sriprasad, Seshadri

AU - Durutovic, Otas

AU - Arumuham, Vimoshan

AU - Ferretti, Stefania

AU - Kamal, Wissam

AU - Xu, Ke Wei

AU - Cheng, Fan

AU - Gao, Xiao Feng

AU - Cheng, Ji Wen

AU - Somani, Bhaskar

AU - Duvdevani, Mordechai

AU - Git, Kah Ann

AU - Seitz, Christian

AU - Bernardo, Norberto

AU - Ibrahim, Tarek Ahmed Amin

AU - Aquino, Albert

AU - Yasui, Takahiro

AU - Fiori, Cristian

AU - Knoll, Thomas

AU - Papatsoris, Athanasios

AU - Gadzhiev, Nariman

AU - Zhanbyrbekuly, Ulanbek

AU - Angerri, Oriol

AU - Ramos, Hugo Lopez

AU - Saltirov, Iliya

AU - Moussa, Mohamad

AU - Giusti, Guido

AU - Vicentini, Fabio

AU - Suarez, Edgar Beltran

AU - Pearle, Margaret

AU - Preminger, Glenn M.

AU - Wu, Qing Hui

AU - Ghani, Khurshid

AU - Maroccolo, Marcus

AU - Brehmer, Marianne

AU - Osther, Palle J.

AU - Zawadzki, Marek

AU - Tursunkulov, Azimdjon

AU - Kytaibekovich, Monolov Nurbek

AU - Abuvohidov, Abdusamad Abdukakhorovich

AU - Lara, Cesar Antonio Recalde

AU - Noori, Zamari

AU - Zanetti, Stefano Paolo

AU - Shrestha, Sunil

AU - de la Rosette, Jean

AU - Denstedt, John

AU - Ye, Zhang Qun

AU - Sarica, Kemal

AU - Choong, Simon

PY - 2024/12

Y1 - 2024/12

N2 - Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts’ experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

AB - Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts’ experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

KW - Expert consensus

KW - Kidney stone

KW - Miniaturized PCNL (mPCNL)

KW - Operation

KW - Percutaneous nephrolithotomy (PCNL)

UR - http://www.scopus.com/inward/record.url?scp=85207795864&partnerID=8YFLogxK

U2 - 10.1186/s40779-024-00562-3

DO - 10.1186/s40779-024-00562-3

M3 - Journal article

C2 - 39465407

AN - SCOPUS:85207795864

SN - 2095-7467

VL - 11

JO - Military Medical Research

JF - Military Medical Research

IS - 1

M1 - 70

ER -

International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

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