Kamal Wissam Khalid, Alhazmy Ali, Alharthi Majed, Al Solumany Aiman
Department of Urology, King Fahd Hospital, Jeddah, Saudi Arabia.
Urol Ann. 2020 Oct-Dec;12(4):352-359. doi: 10.4103/UA.UA_100_19. Epub 2020 Oct 15.
The objective of the study was to present the current practice patterns on percutaneous nephrolithotomy (PCNL) in Saudi Arabia and to compare it with the international patterns and to observe the adherence to the guidelines.
A survey consisting of 28 questions was sent to urologists working in Saudi Arabia using a Google Forms questionnaire. The questioner covered most aspects of performing PCNL starting from preparing the patient till discharging him.
One hundred and thirty-two replied to the survey. Almost 70.2% performed PCNL and 59.1% of them learned PCNL during residency. The access was obtained by the urologists in 80.3% from the participants, 68.2% of them uses fluoroscopic guidance for the puncture. The majority (80.3%) perform PCNL in the prone position. Nearly 69.7% use the balloon dilators and 16.7% use the Amplatz dilators. For kidney drainage, 60.6% place a nephrostomy tube and a double-J stent (DJ stent) together and 4.5% perform tubeless PCNL (DJ stent only). About 45.5% stated that the introduction of flexible ureteroscopy decreased the rate of doing PCNL for >20%.
Data obtained from a group of urologists in Saudi Arabia showed that the majority of urologists practicing in Saudi Arabia perform PCNL. They usually learn PCNL during residency. We observe that the majority of urologists attach to the original patterns in PCNL, i.e., they predominantly prefer the prone position and use fluoroscopy to gain the PCNL access. Furthermore, the data showed that new trends in PCNL did not gain a lot of momentum as few practices miniaturized PCNL and tubeless PCNL. The majority use balloon dilators and combined ultrasonic/pneumatic lithotripters. The complication rate encountered by the participants is concomitance with the published international figures. The introduction of flexible ureteroscopy highly decreased the rate of doing PCNL for most urologists.
本研究的目的是介绍沙特阿拉伯经皮肾镜取石术（PCNL）的当前实践模式，并将其与国际模式进行比较，以及观察对指南的遵循情况。
使用谷歌表单问卷向在沙特阿拉伯工作的泌尿外科医生发送了一份包含28个问题的调查问卷。该问卷涵盖了从患者准备到出院的PCNL操作的大多数方面。
132人回复了调查。近70.2%的人进行PCNL，其中59.1%在住院医师培训期间学习了PCNL。80.3%的参与者中泌尿外科医生获得了穿刺通道，其中68.2%在穿刺时使用荧光透视引导。大多数（80.3%）在俯卧位进行PCNL。近69.7%使用球囊扩张器，16.7%使用Amplatz扩张器。对于肾脏引流，60.6%同时放置肾造瘘管和双J支架（DJ支架），4.5%进行无管PCNL（仅DJ支架）。约45.5%表示，软性输尿管镜的引入使PCNL的实施率降低了>20%。
从沙特阿拉伯一组泌尿外科医生获得的数据表明，在沙特阿拉伯执业的大多数泌尿外科医生进行PCNL。他们通常在住院医师培训期间学习PCNL。我们观察到，大多数泌尿外科医生遵循PCNL的原始模式，即他们主要倾向于俯卧位并使用荧光透视来获得PCNL穿刺通道。此外，数据显示PCNL的新趋势没有获得很大的发展势头，因为很少有医生采用微创PCNL和无管PCNL。大多数人使用球囊扩张器和联合超声/气压弹道碎石机。参与者遇到的并发症发生率与已发表的国际数据一致。软性输尿管镜的引入使大多数泌尿外科医生进行PCNL的比率大幅下降。
