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"ABSTRACTPurposeLung transplantation is accepted as an effective modality for patients with end-stage pulmonary lymphangioleiomyomatosis (LAM). Generally, bilateral lung transplantation is preferred to single lung transplantation (SLT) for LAM because of native lung-related complications, such as pneumothorax and chylothorax. It remains controversial whether SLT is a suitable surgical option for LAM. The objective of this study was to evaluate the morbidity, mortality and outcome after SLT for LAM in a lung transplant center in Japan.MethodsWe reviewed the records of 29 patients who underwent SLT for LAM in our hospital between March, 2000 and November, 2017. The data collected included the pre-transplant demographics of recipients, surgical characteristics, complications, morbidity, mortality and survival after SLT for LAM.ResultsThe most common complication after SLT for LAM was contralateral pneumothorax (n = 7; 24.1%). Six of these recipients were treated successfully with chest-tube placement and none required surgery for the pneumothorax. The second-most common complication was chylous pleural effusion (n = 6; 20.7%) and these recipients were all successfully treated by pleurodesis. The 5-year survival rate after SLT for LAM was 79.5%.ConclusionLAM-related complications after SLT for this disease can be managed. SLT is a treatment option and may improve access to lung transplantation for patients with end-stage LAM."

"ABSTRACTPurpose: Laparoscopic splenectomy (LS) has become the standard operative approach for splenectomy. Portal or splenic vein thrombosis (PSVT) is a serious and common complication after LS, and lethal complications of PSVT can occur when the portal vein is completely occluded by portal vein thrombosis (PVT). We aimed to clarify the predictors of PSVT after LS and to determine which of them were also predictors of PVT.Methods: A total of 56 consecutive patients who underwent elective LS were enrolled in this study. The patients were divided into two groups based on the presence or absence of PSVT after LS. In addition, patients with PSVT were divided into two groups: a PVT group and a non-PVT group. The preoperative and intraoperative clinical data were compared among the groups.Results: Thirty (53.6%) patients developed PSVT. The splenic vein diameter was the most useful predictor for the development of PSVT, and 10 mm was an accurate splenic vein diameter cut-off value for use as a predictive factor for PSVT. In addition, the splenic vein diameter was the most useful predictor of the development of PVT from splenic vein thrombosis (SVT), and 14 mm was found to be an accurate cut-off value.Conclusion: PSVT is a common postoperative complication that is identified on enhanced computed tomography. The splenic vein diameter is not only a predictor of PSVT but also of the development of PVT from SVT."

"Introduction and Objectives: Supine Percutaneous Nephrolithotomy (PCNL) is believed to provide more limited space for percutaneous access than prone position. This disadvantage is usually fixed by modifying the supine position with supporting pad. Our study aims to compare the safety, efficacy, and other surgical outcomes of supine PCNLs performed with and without the use of supporting padMethod: This study was a retrospective study in patients who undergone PCNL procedure with supine position for renal stones with all sizes between January - December 2019. Divided into two groups, operated with and without supporting pad, with 13 and 14 patients respectively. Several parameters such as operation duration, intraoperative blood loss, post operative double J stent usage, stone free rate dan length of stay were observed.Results: There were 27 patients, as subjects of the study. Our observation showed no statistically significant difference between the two groups, although blood loss and length of stay in supporting pad showed better results. Statistically significant difference was found in stone-free-rate (P=0.006) favoring in supine PCNL with supporting pad.Conclusion: Supine PCNL with support padding may be a safe and more effective choice to treat renal stones. Nevertheless, patient’s anatomic variations may influence this. Thus, a prospective study with a larger population is needed to verify our outcomes.

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Pendahuluan dan tujuan: Percutaneous Nephrolithotomy (PCNL) posisi supine memiliki kelemahan akses perkutan yang lebih terbatas dibandingkan posisi prone. Hal ini biasanya diatasi dengan modifikasi posisi supine menggunakan bantalan penopang. Penelitian kami bertujuan membandingkan keamanan, efikasi, dan luaran surgikal lainnya dari PCNL posisi supine dengan dan tanpa bantalan penopang.

Metode: Penelitian ini merupakan penelitian retrospektif terhadap pasien yang menjalani prosedur PCNL posisi supine untuk tatalaksana batu ginjal dengan berbagai ukuran pada Januari-desember 2019. Pasien tersebut dibagi menjadi dua kelompok, yaitu kelompok yang dioperasi menggunakan bantalan penopang dan kelompok tanpa bantalan penopang, masing-masing berjumlah 13 dan 14 pasien. Beberapa parameter diamati antara lain durasi operasi, perdarahan intraoperatif, penggunaan double J stent post operasi, stone free rate dan lama rawat.

Hasil: Ada 27 pasien yang diteliti pada penelitian ini. Tidak terdapat perbedaan signifikan antara kedua kelompok dari hasil observasi, meskipun perdarahan dan lama rawatan lebih baik pada kelompok dengan bantalan penopang. Perbedaan yang signifikan secara statistik terlihat pada angka bebas batu yang lebih baik pada kelompok dengan bantalan penopang (P=0.006).

Kesimpulan: PCNL posisi supine dengan bantalan penopang merupakan pilihan yang aman dan lebih efektif dalam mengatasi batu ginjal. Meskipun demikian, variasi anatomi pasien dapat mempengaruhi hal ini. Dibutuhkan penelitian prospektif dengan populasi yang lebih besar untuk verifikasi hasil penelitian kami."

"Pendahuluan dan tujuan: Pembedahan laparoskopi telah diakui dapat mengurangi tingkat morbiditas sehingga meningkatkan keselamatan pasien. Saat tindakan LLDN, komplikasi yang paling sering adalah cedera pembuluh darah ginjal, yang sering membutuhkan transfusi darah. Selain perlunya transfusi darah, pendarahan berat yang disebabkan oleh cedera pembuluh ginjal membutuhkan konversi dan perbaikan terbuka. Dengan demikian, penelitian ini ingin mendeskripsikan dan menganalisis kebutuhan transfusi darah dalam operasi laparoscopic living donor nephrectomy di pusat kami.Bahan dan metode:  Studi kohort retrospektif ini dilakukan di Departemen Urologi di Rumah Sakit Nasional Cipto Mangunkusumo. Rekam medis semua pasien donor ginjal yang menjalani prosedur LLDN di institusi kami dari November 2011 hingga Oktober 2017 ditinjau. Data termasuk usia donor, kadar hemoglobin sebelum operasi, kadar hemoglobin pasca operasi, jumlah pendarahan intraoperatif, jumlah arteri renalis, jumlah vena renalis, sisi donor, konversi ke operasi terbuka, durasi operasi, dan BMI donor dikumpulkan dan dianalisis. Data-data ini selanjutnya dikorelasikan dengan tingkat transfusi.Hasil: Terdapat 500 pasien yang menjalani tindakan laparoscopic living donor nephrectomy di institusi kami. Semua pasien menjalani prosedur LLDN dengan pendekatan transperitoneal. Perbedaan proporsi tingkat transfusi darah antara pasien pria 0,9% dibandingkan dengan 0,6% pada pasien wanita tidaklah signifikan (p=0,782). Tidak ada perbedaan yang signifikan dalam proporsi tingkat transfusi darah dengan sisi ginjal (p=0,494), jumlah arteri (p=0,362), usia (p=0,978), BMI (p=0,569), dan kadar hemoglobin sebelum operasi (p=0,766). Median perkiraan jumlah pendarahan pada pasien yang menerima transfusi darah intraoperatif secara signifikan lebih besar daripada pasien yang tidak menerima transfusi darah (p <0,001).Kesimpulan: Berdasarkan penelitian ini, kami menyarankan bahwa di institusi kami, penggunaan produk darah pra operasi tidak selalu diperlukan. Kurva pembelajaran dan teknik ahli bedah memiliki peran penting dalam mencegah komplikasi intraoperatif dan kehilangan darah.

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Introduction and objectives: Laparoscopic surgery has been acknowledged to reduce the morbidity rate thus improving patient safety. During the LLDN, the most frequent complication is renal vessels injuries, which often requires a blood transfusion. Besides the need for a blood transfusion, major bleeding caused by renal vessels injuries require open conversion and repair. Thus, this study would like to descript and analyze the need for blood transfusion in laparoscopic living donor nephrectomy surgery in our center.Materials and methods: We performed a retrospective cohort study in the Department of Urology at Cipto Mangunkusumo National Hospital. The records of all kidney transplantation donor patients who underwent LLDN procedures carried out at our institution from November 2011 to October 2017 were reviewed. Data including donor age, preoperative hemoglobin level, postoperative hemoglobin level, intraoperative bleeding, number of artery(ies), number of vein(s), donor side, conversion to open surgery, surgery duration, and donor BMI were collected and analyzed. These data were further correlated with transfusion rate.Results: There were 500 patients underwent laparoscopic living donor nephrectomy procedure at our institution. All of the patients had LLDN with a transperitoneal approach. The difference in blood transfusion rate proportion between male patients with 0.9% compared to 0.6% in female patients was not significant (p=0.782). There are no significant difference in blood transfusion rate proportion regarding to renal side (p=0.494), number of artery (p=0.362), age (p=0.978), BMI (p=0.569), and preoperative hemoglobin (p=0.766). Median estimated blood loss in patients who received intraoperative blood transfusion was significantly much greater than in patients who did not receive a blood transfusion (p<0.001).Conclusion: Based on this study, we suggest that in our institution, preoperative blood products are not necessarily needed. The surgeon's learning curve and technique play a significant role in preventing intraoperative complications and blood loss."

"Backgrounds : Percutaneous nephrolithotomy (PCNL) is a standard procedure for treating renal stones. However, the optimal guidance method between ultrasound (US) and fluoroscopy remains debatable. The principle to reduce radiation exposure through ALARA principle is also heavily considered. This study aims to compare the efficacy and safety of US-guided versus fluoroscopy-guided PCNL in a single center over a 5-year period.Methods: A retrospective cohort analysis of patients who underwent PCNL between 2018 and 2023 were conducted. Patients were categorized into two groups: US-guided and fluoroscopy-guided PCNL. Outcomes evaluated were stone-free rates (SFRs), fluoroscopy usage duration and intraoperative radiation.Results: A total of 658 patients (US-guided, n=563; fluoroscopy-guided, n=95) were included. The SFRs were comparable between the two groups (p > 0.05). Meanwhile, significantly lower amounts of fluoroscopy usage duration, effective dose, and radiation exposure was found for the US-guided group (p < 0.05). Additionally, operative time was significantly faster in the US-guided procedure, despite requiring more punctures (p < 0.05). Complication rates were similar between both groups.Conclusion: US-guided PCNL presents as an effective and safe alternative to fluoroscopy-guided PCNL with the added advantage of avoiding radiation exposure.

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Latar Belakang: Nefrolitotomi perkutan (PCNL) adalah prosedur standar untuk tatalaksana batu ginjal. Namun, metode panduan yang optimal antara ultrasound (USG) dan fluoroskopi masih menjadi perdebatan. Prinsip untuk mengurangi paparan radiasi melalui prinsip ALARA juga sangat dipertimbangkan. Penelitian ini bertujuan untuk membandingkan efikasi dan keamanan PCNL yang dipandu USG versus PCNL yang dipandu fluoroskopi dalam satu pusat selama periode 5 tahun.

Metode: Analisis kohort retrospektif terhadap pasien yang menjalani PCNL antara tahun 2018 dan 2023 dilakukan. Pasien dikategorikan ke dalam dua kelompok: PCNL dengan panduan USG dan PCNL yang dengan panduan fluoroskopi. Hasil yang dievaluasi adalah angka bebas batu/stone free rate (SFR), durasi penggunaan fluoroskopi dan radiasi intraoperatif.

Hasil: Sebanyak 658 pasien (dipandu oleh USG, n = 563; dipandu oleh fluoroskopi, n = 95) diikutsertakan. SFR sebanding antara kedua kelompok (p > 0,05). Sementara itu, jumlah durasi penggunaan fluoroskopi, dosis efektif, dan paparan radiasi yang jauh lebih rendah ditemukan pada kelompok yang dipandu oleh AS (p <0,05). Selain itu, waktu operasi secara signifikan lebih cepat pada prosedur yang dipandu oleh US, meskipun membutuhkan lebih banyak tusukan (p <0,05). Tingkat komplikasi serupa antara kedua kelompok.

Kesimpulan: PCNL dengan panduan USG hadir sebagai alternatif yang efektif dan aman untuk PCNL dengan panduan fluoroskopi dengan keuntungan tambahan untuk menghindari paparan radiasi."

"Pendahuluan: Penelitian ini bertujuan untuk menggambarkan uretroplasti satu tahap dan fakto-faktor yang berhubungan dengan kejadian fistel urethrokutan pada institusi kami.Metode: Semua pasien hipospadia denga riwayat belum pernah dioperasi sebelumnya dan dilakukan tindakan rekonstruksi uretroplasti satu tahap. Data diambil dari Juli 2010 sampai dengan Januari 2018. Terdapat 179 pasien yang diikutkan dan di observasi minimal selama 1 tahun pasca operasi. Data-data yang dikumpulkan berupa tipe hipospadia, teknik operasi, derajat chordee, pre-operatif piuria (sel darah putih urin > 5/HPF), panjang defek dari urethra, dan kejadian fistel urethrokutan.Hasil: Penelitian berhasil mengumpulkan sejumlah kasus hipospadia yang terdiri dari 103 posterior (57.5%), tengah (57 kasus), dan anterior (19 kasus) yang mana dilakukan onlay preputial island flad (71 kasus), Snodgrass’ tubular incised plate (46 kasus), dan Duckket transverse preputial island flap (35 kasus). Setelah observasi selama 47.1 ± 25.8 bulan, fistel urethrokutan ditemukan pada 23 pasien (12.8%), yang diasosiasikan dengan hipospadia posterior (p = 0.025), defek urethral yang lebih panjang (p = 0.007), dan preoperative piuria (p < 0.001). Sementara derajat chordee (p = 0.886) dan usia (p = 0.187) bukanlah faktor resiko yang signifikan dalam kejadian fistel urethrokutan.Kesimpulan: Uretroplasti satu tahap adalah sebuah prosedur yang serba guna yang dapat digunakan pada berbagai macam kasus hipospadia dengan dengan angka kejadian fistel urethrokutan 12.8%. Hipospadia posterior, pre-operatif piuria, dan defek uretral yang lebih panjang di asosiasikan dengan kejadian fistel urethrokutan

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Introduction: This study aims to describe single-stage urethroplasty and determine factors associated with urethrocutaneous fistula after the procedure in our institution.

Methods: All hypospadias patients without any prior surgery undergone single stage urethroplasty from July 2010 until January 2018 were included. In total, 179 patients were followed for at least 1 year post-operatively. Types of hypospadias, operation techniques, chordee degree, preoperative pyuria (urine white blood cell >5/HPF), urethral length defect, and urethrocutaneous fistula formation were collected.

Results: We obtained 103 cases of posterior (57.5%), middle (57 cases), and anterior (19 cases) hypospadias on whom onlay preputial island flap (71 cases), Snodgrass’ Tubular Incised Plate (46 cases), and Duckett’s transverse preputial island flap (35 cases) were conducted. After 47.1 ± 25.8 months follow up, urethrocutaneous fistula were found in 23 patients (12.8%) associated with posterior hypospadias occurrence (p = 0.025), longer urethral defect (p = 0.007), and preoperative pyuria (p < 0.001). Whilst chordee degree (p = 0.886) and age (p = 0.187) was not significant factor associated with urethrocutaneous fistula formation.

Conclusion: Single-stage urethroplasty is a versatile procedure for various hypospadias cases with urethrocutaneous fistula rate 12,8%. Posterior hypospadias, preoperative pyuria, and longer urethral defect were associated with urethrocutaneous fistula formation"

"Introduction:Bladder stones, a common urological condition, can significantly impact a patient's quality of life, leading to symptoms such as obstructive lower urinary tract symptoms (LUTS) and hematuria. In recent years, the utilization of laser lithotripsy has emerged as a promising technique for the removal of bladder stones, offering potential advantages in terms of efficacy and safety. Material & Methods:Data obtained from the medical record was collected retrospectively since the use of laser lithotripsy in 2019. Patients who fulfilled the inclusion and exclusion criteria were included. Data on patients’ age, sex, symptoms, maximum stone diameter, operation duration, complications, and length of in-hospital duration were gathered and analyzed using SPSS v.27. The primary endpoint was to assess the stone size being successfully removed and procedure duration. Results:We recruited 46 participants (40 men and 6 women) with a mean age of 55,5 years old. In 18 (39%) participants, obstructive LUTS was the main presenting symptom, followed by hematuria in 9 (19%) patients. In 10 (28%) of cases, work-up was done by plain abdominal x-ray, while the remaining 36 (72%) underwent CT-scan. The mean surgery duration was 57,2 ± 22,3 minutes. Out of subjects, 3 (6,5%) experienced hematuria as a side effect while 1 (2,1%) patient had a fever. Conclusion:Our data demonstrated a safe and effective result of laser lithotripsy used for bladder stones removal. More research is warranted to compare the current modality applied in Indonesia general hospitals along with cost analysis to provide the best treatment option for the patients.

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Pendahuluan:

Batu kandung kemih, kondisi urologi yang umum, dapat secara signifikan mempengaruhi kualitas hidup pasien, menyebabkan gejala seperti gejala obstruktif saluran kemih bawah (LUTS) dan hematuria. Dalam beberapa tahun terakhir, penggunaan litotripsi laser telah muncul sebagai teknik yang menjanjikan untuk pengangkatan batu kandung kemih, menawarkan potensi keuntungan dalam hal efektivitas dan keamanan.

Metode:

Data yang diperoleh dari catatan medis dikumpulkan secara retrospektif sejak penggunaan litotripsi laser pada tahun 2019. Pasien yang memenuhi kriteria inklusi dan eksklusi diikutsertakan. Data tentang usia, jenis kelamin, gejala, diameter batu maksimum, durasi operasi, komplikasi, dan lama rawat inap pasien dikumpulkan dan dianalisis menggunakan SPSS v.27. Titik akhir utama adalah menilai ukuran batu yang berhasil diangkat dan durasi prosedur.

Hasil :

Penelitian ini terdapat 46 subjek (40 pria dan 6 wanita) dengan usia rata-rata 55,5 tahun. Pada 18 subjek (39%), gejala utama yang muncul adalah obstruksi, diikuti oleh hematuria pada 9 pasien (19%). Pada 10 kasus (28%), pemeriksaan dilakukan dengan X-ray abdomen, sedangkan 36 lainnya (72%) menjalani CT-scan. Rata-rata durasi operasi adalah 57,2 ± 22,3 menit. Tiga orang (6,5%) mengalami hematuria sebagai efek samping sementara 1 pasien (2,1%) mengalami demam.

Kesimpulan:

Penggunaan litotripsi laser untuk menghilangkan batu kandung kemih aman dan efektif. Penelitian lebih lanjut diperlukan untuk membandingkan metode saat ini yang diterapkan di rumah sakit umum di Indonesia, serta analisis biaya untuk memberikan opsi pengobatan terbaik bagi pasien."

"Tujuan: Untuk melihat respon pemberian regimen kemoterapi paclitaxel, ifosfamide, dan cisplatin pada pasien dengan kanker penis. Metode Penelitian: Pasien SCC penis dengan pembesaran kelenjar getah bening di inguinal dan pelvik di RS. Haji Adam Malik dari tahun 2014 sampai 2016 diinklusikan. Kami menggunakan regimen kemoterapi TIP yaitu paclitaxel 175 mg/m2 pada hari 1, ifosfamide 1200 mg/m2 pada hari 1-3, dan cisplatin 25 mg/m2 pada hari 1-3 setiap 21-28 hari. Hasil Penelitian: Selama 2 tahun terdapat 17 pasien kanker penis dengan keterlibatan kelenjer getah bening yang mendapat regimen TIP dengan rata-rata umur pasien 44,18 11,13. Hanya 10 pasien yang menyelesaikan kemoterapi secara penuh. Dari 10 pasien, tidak ada yang menunjukkan komplit respon. Enam pasien menunjukkan parsial respon, 3 pasien stabil respon dan 1 pasien progresif. Kaplan-Meier overall survival rate OS adalah 6 bulan 95 CI: 4,4-7,6 bulan . Median waktu follow up adalah 7 bulan antara 1 sampai 11 bulan . Analisis subgrup, OS pasien yang memiliki respon lebih baik secara signifikan bila dibandingkan dengan yang tidak berespon log-rank test, p?0,004 . Kesimpulan: Kemoterapi TIP memberikan manfaat klinik pada pasien kanker penis dengan penyebaran kelenjer getah bening.

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Aim This study was conducted to evaluate the response of penile cancer patients who were in TIP Paclitaxel, Ifosfamide, Cisplatin regimen. Method We included all medical records of penile squamous cell carcinoma patients associated with nodal involvement who acquired TIP regimen in Adam Malik Hospital between 2014 and 2016. We administered 175 mg m2 of Paclitaxel on day 1, 1200 mg m2 of Ifosfamide on day 1 3, and 25 mg m2 of Cisplatin on day 1 3 every 21 28 days. Results We extracted data from 17 patients of penile cancer with nodal involvement who acquired TIP regimen with mean age of 44.18 11.13 years old from our medical records. Only 10 patients completed 4 cycles of the regimen. There was no complete respond noted. Six patients were noted as partial respond and 1 patient was noted as progressive disease. The Kaplan Meier curve shows an overall 6 months 95 CI 4.4 7.6 months of survival with median of follow up time was 7 1 11 months. In subgroup analysis, we found that the responder group have significantly better overall survival than the non responder group log rank test, p 0.004 . Conclusion TIP regimen gives significant clinical benefit in penile cancer with nodal involvement. "

"Latar Belakang dan Tujuan: Meskipun PCNL tradisional memiliki stone-free rate yang tinggi, kadang-kadang dikaitkan dengan morbiditas pengobatan yang signifikan. Di seluruh dunia, versi miniatur dari PCNL konvensional (Mini-PCNL) telah digunakan. Menurut literatur yang tersedia, Mini-PCNL memiliki morbiditas yang lebih rendah dan stone-free rate yang serupa dengan PCNL konvensional. Dalam penelitian ini kami bertujuan untuk mendeskripsikan karakteristik pasien yang menjalani mini-PCNL di pusat kami di Jambi, Indonesia.Metode: Ini adalah studi deskriptif yang melibatkan pasien batu ginjal yang diobati dengan mini- PCNL selama 2017 – 2021 di Jambi, Indonesia. Pemilihan subjek penelitian menggunakan metode total sampling. Semua pasien memiliki riwayat medis yang diambil dan pemeriksaan fisik dilakukan sebelum operasi. Prosedur dilakukan oleh tiga operator di satu rumah sakit kabupaten rujukan. Hasil: Selama periode 2017 hingga 2021, pusat kami telah melakukan 188 prosedur mini-PCNL untuk pengangkatan batu ginjal. Namun, hanya 186 kasus yang dimasukkan dalam studi ini setelah mengesampingkan 2 kasus karena data yang tidak lengkap. Dari 186 kasus tersebut, sebanyak 165 pasien menjalani prosedur mini-PCNL. Usia rata-rata pasien dalam penelitian ini adalah 49,3 tahun (berkisar antara 12-87 tahun) dengan mayoritas laki-laki (101/165). [61,21%]). Waktu operasi rata- rata adalah 113,5 ± 50,5 menit, dan rata-rata lama tinggal di rumah sakit adalah 2,8 ± 1,3 hari. Dari 186 kasus, sebanyak 175 kasus tidak memiliki sisa batu dan hanya 11 yang memiliki sisa batu (stone- free rate [SFR] 94,08%). Sebagian besar pasien mengalami hidronefrosis, dan penempatan DJ stent dilakukan pada 44 dari 186 kasus. SFR menurun seiring dengan peningkatan ukuran batu Kesimpulan: Mini-PCNL terbukti menjadi pilihan yang baik untuk mengelola batu ginjal, terutama untuk batu berukuran sedang dan keras, memberikan hasil yang lebih baik dan mengurangi komplikasi pasca-operasi.

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Background and Aim: Although traditional PCNL has a high stone-free rate, it is sometimes associated with significant treatment morbidity. Worldwide, a miniaturized version of a conventional PCNL (Mini-PCNL) has been used. According to the available literature, Mini-PCNL has lower morbidity and a similar stone-free rate to conventional PCNL. In this study we aim to describe the characteristics of patients undergoing mini- PCNL at our center in Jambi, Indonesia.

Methods: This is a descriptive study involving patients with kidney stones treated with mini-PCNL during 2017 – 2021 in Jambi, Indonesia. The selection of the study subjects was using total sampling method. All patients had a medical history taken and a physical examination performed prior to surgery. The procedure was performed by three operators in one referral district hospital.

Results: From 2017 to 2021, a total of 188 mini-PCNL procedures were performed at our center for the removal of kidney stones. However, only 186 cases were included in this study after excluding 2 due to incomplete data. The mean age of patients in this study was 49.3 years old (ranging from 12–87 years old) with the majority being a male (101/165 [61.21%]). Of 186 cases, a total of 175 cases having no residual stone and only 11 having residual stone (stone-free rate [SFR] 94.08%). Most patients presented with hydronephrosis, and DJ stent placement was performed in 44 out of 186 cases. The SFR decreased as the stone size increased.

Conclusion: Mini-PCNL proves to be a valuable choice for managing kidney stones, especially for medium-sized and hard stones, leading to enhanced patient results and reduced post-operative complications."

"ABSTRACTPurpose: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx.Methods: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications.Results: Among the 160 LTx recipients, 58 (36.3%) suffered a collective 70 gastrointestinal complications, the most frequent being gastroparesis, followed by gastroesophageal reflux disease. Two complications were managed surgically, by Nissen fundoplication for gastroesophageal reflux disease in one recipient and Hartmann's operation for sigmoid colon perforation in one. The other 68 complications were managed medically. Two patients died of complications: one, of aspiration pneumonia caused by gastroparesis; and one, of panperitonitis caused by a gastric ulcer. There were no significant differences in overall survival or chronic lung allograft dysfunction-free survival between the patients with and those without gastrointestinal complications.Conclusions: Gastrointestinal complications are not uncommon in LTx recipients and may be serious; therefore, early detection and appropriate treatment are imperative. Surgical management is required for some complications, but most can be managed medically."