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Minerva Urologica e Nefrologica 2021 Jan 13

DOI: 10.23736/S0393-2249.20.04107-7


language: English

Classification and Standardized Reporting of Percutaneous Nephrolithotomy (PCNL): International Alliance of Urolithiasis (IAU) consensus statements

Simon CHOONG 1, Jean de la ROSETTE 2, John DENSTEDT 3, Guohua ZENG 4, Kemal SARICA 5, Giorgio MAZZON 6 , Iliya SALTIROV 7, Shashi K. PAL 8, Madhu AGRAWAL 9, Janak DESAI 10, Aleš PETRIK 11, Noor BUCHHOLZ 12, Marcus V. MAROCLO 13, Stephen GORDON 14, Ashwin SRIDHAR 1

1 Institute of Urology, University College London Hospitals, London, UK; 2 Department of Urology, Istanbul Medipol University, Istanbul, Turkey; 3 Division of Urology, University of Western Ontario, London, Canada; 4 Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; 5 Department of Urology, Biruni University, Medical School in Istanbul, Turkey; 6 Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy; 7 Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria; 8 Department of Urology, Apollo group of Hospitals & Holy Family Hospital at New Delhi, India; 9 Department of Urology & Centre for Minimally-invasive Endourology, Global Rainbow Healthcare, Agra, India; 10; Department of Urology, Samved Hospital, Ahmedabad, India; 11 Department of Urology, Region Hospital Ceske Budejovice, Prague, Czech Republic; 12 Department of Urology, Sobeh’s Vascular & Medical Center, Dubai Healthcare City, Dubai, United Arab Emirates; 13 Endourology Unit, Hospital de Base of the Federal District, Brasília, Brazil; 14 Department of Urology, Epsom & St. Helier University Hospitals NHS Trust, Surrey, UK


BACKGROUND: To reach a consensus in the classification and standardized reporting for the different types of PCNLs.
METHODS: The RAND/UCLA appropriateness methodology was used to reach a consensus. Thirty-two statements were formulated reviewing the literature on guidelines and consensus on PCNLs, and included procedure specific details, outcome measurements and a classification for PCNLs. Experts were invited to two rounds of input, the first enabled independent modifications of the proposed statements and provided the option to add statements. The second round facilitated scoring of all statements. Each statement was discussed in the third round to decide which statements to include. Any suggestion or disagreement was debated and discussed to reach a consensual agreement.
RESULTS: Twenty-five recommendations were identified to provide standardised reporting of procedure and outcomes. Consensual scoring above 80% were strongly agreed upon by the panel. The top treatment related outcomes were size of sheath used (99.1%) and position for PCNL (93.5%). The highest ranked Outcome Measures included definition of post-operative hospital length of stay (94.4%) and estimated blood loss (93.5%).
CONCLUSIONS: The consensus statements will be useful to clarify operative technique, in the design of clinical trials and standardized reporting, and presentation of results to compare outcomes of different types of PCNLs.

KEY WORDS: Classification; Standardization; Percutaneous nephrolithotomy; Miniaturization; Consensus; Sheath size

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