فهرست مطالب keivan gholamjani moghaddam

 Percutaneous nephrolithotomy (PNL) is the treatment of choice for renal stones as a safe, effective, and minimally invasive method. However, bleeding remains a major concern in the procedure.

 This study aimed to investigate the risk factors of bleeding in PNL.

 This retrospective descriptive cross-sectional study was conducted in the Urology department of Razi hospital. The data of patients with urinary calculi staghorn type who underwent PNL in a prone position under general anesthesia were recorded. A checklist including patients' demographics, surgical characteristics, and outcomes was filled out for each patient.

 The data from 151 complete files were gathered. The mean age of the cases was 47.89 ± 12.41 years. The mean hemoglobin (Hb) drop was 1.92 ± 1.56 mg/dL. At least 1 mg/dL Hb drop was observed in all cases. The highest Hb drop was 3 mg/dL.). There was no significant relationship between stone bulk, age, BMI, GFR, surgery duration, and the number of tracts, and Hb drop during PNL (P > 0.05). But there was a positive correlation between Urinary Tract Infection (UTI) history (P = 0.01) and transfusion (P = 0.0001) and Hb drop during PNL. Also, the history of open kidney surgery (P = 0.031), nephrostomy insertion (P = 0.003), and extracorporeal shock wave lithotripsy therapy (ESWL) (P = 0.041) were correlated with the increased risk of Hb drop.

 Urinary tract infection, history of open surgery, nephrostomy implantation, and ESWL were significantly associated with more bleeding in PNL.

The present study aimed to assess the association between stone chemical compositions and Percutaneous Nephrolithotomy (PCNL) outcomes (stone-free result, operative time).

In this analytical cross-sectional study, the data of 113 patients who underwent PCNL, including stone chemical composition, stone-free result, and operative time, were recorded and analyzed.

In univariate analysis, no significant differences were observed between the group with the stone-free result and the group without stone-free result in mean percentages of calcium phosphate, calcium oxalate, uric acid, and the frequency of infectious stones time (P>0.05). Moreover, operative time was not significantly correlated with the percentages of calcium phosphate, calcium oxalate, and uric acid components (P>0.05). In addition, no significant difference was detected between the two groups (with and without infectious stones) in terms of mean operative time (47.00±17.38 vs. 45.99±20.98; P=0.817). In multivariate regression analysis, none of calcium phosphate, calcium oxalate, uric acid, and infectious stone were the predictive factors affecting stone-free result and operative time.

As evidenced by the obtained results, the compositions of upper urinary tract stones had no effect on the stone-free result and operative time in PCNL.

To compare outcomes and complications of percutaneous nephrolithotomy (PCNL) in the complete supine versus semi supine position in order to select the best position.
In this clinical trial, between July 2011 and May 2014, a total of 44 patients who presented for PCNL were prospectively enrolled and randomly divided into 2 groups [complete supine (n=22), and semi supine (n = 22)]. The results in both positions were compared regarding the complexity and outcomes. Stone free rate was considered as a main target of the study. However, it was the first study to focus on overlapping the vertebral density during the access.
The two groups were comparable in age, gender, body mass index, and preoperative glomerular filtration rate, hemoglobin and creatinine. The mean operative time was significantly shorter for complete supine versus semi supine (36.68 ± 14.12 min versus 47.50 ± 16.45 min, P = .024). At the angle of 0?, overlapping with the spine occurred in 7 patients (31.8%) in semi supine group and just in 1 patient (4.5%) in complete supine group. Also, overlapping with the edge of bed occurred in 10 cases (45.5%) of complete supine and 1 (4.5%) of semi supine; the differences were statistically significant (P = .023, P = .002, respectively). No significant difference was found between the two groups in terms of stone free rate and complications.
Although, we had to convert two cases from semi supine into the complete supine position but we have demonstrated that PCNL in both positions is safe, effective and suitable for the patients. The stone free rate was similar in both groups. But the complete supine position is associated with a significantly shorter postoperative hospital stay and operative time, which may improve ease and safety of PCNL for patients.

To determine the frequency of human leukocyte antigen (HLA)-B5 in patients with bladder cancer compared with normal population. In this cross sectional study, from November 2009 until November 2010, 35 patients with pathologic diagnosis of bladder cancer who referred to urology clinic of Razi Hospital were studied. Also, 130 healthy transplant donation volunteers who referred for HLA-typing to Guilan Blood Transfusion Organization, were selected. Inclusion criterion was pathologic diagnosis of bladder cancer regardless of stage and grade of tumor. Exclusion criteria were presence of other urologic diseases. The information of these cases was extracted from medical records, collected and analyzed. HLA-B5 was positive in 34.3% of the patient group and in 39.2% of the controls. Statistical analysis showed no significant association between HLA-B5 and bladder cancer (P =. 15). There were no significant differences between grade (P =. 107) and relapse (P =. 327) of bladder tumor with presence of HLA-B5. There was no significant association between HLA-B5 and bladder cancer. The grade and the relapse of tumor had no association with presence or absence of HLA-B5.