Re: Shahrour et al.: Predictors ?f immediate Postoperative Outcome of Single-tract Percutaneous Nephroiithotomy (Urology 2012;80:19-26)

摘要

We read the article on single-tract percutaneous neph' rolithotomy (PCNL) in which the authors use a singletract, flexible nephroscope (with holmium laser litho-tripsy) and simultaneous retrograde flexible ureteroscopy to maximize stone clearance and thus avoid multitract PCNL and its complications. The authors, however, do not mention whether every patient required flexible instruments or whether their use was limited to select cases. PCNL is considered the, reference standard, because it is easy to learn, easy to teach, inexpensive, widely available worldwide, safe, and gives good results. We are apprehensive that the introduction of expensive flexible instruments and laser in PCNL would result in PCNL no longer being considered the reference standard. This is because it would be difficult to introduce expensive flexible instruments and laser to most centers in the world, and these would thus be restricted to a few sophisticated centers and might also decrease hospital turnover (owing to an increase in operative time).