Peer-reviewedCC BY-NC-SACentral European journal of urology15 May 2026

Simultaneous single-tract percutaneous nephrolithotomy and intrarenal laser marsupialization via non-cyst-transgressing access: A pilot case series.

Huy-Hoang Nguyen^1,2
Ngoc-Son Do¹
Van-Hung Le³

¹Department of Urology, VietDuc University Hospital, Hanoi, Vietnam.
²Department of Surgery, Hanoi Medical University, Hanoi, Vietnam.
³Department of Urology, Vinmec Times City International Hospital, Hanoi, Vietnam.

Abstract

Introduction

Ipsilateral renal stones and simple cysts usually require separate procedures or risk urinary extravasation with cyst-transgressing percutaneous techniques. This pilot study evaluated the safety and feasibility of single-tract percutaneous nephrolithotomy (PCNL) combined with intrarenal holmium:YAG laser marsupialization via a non-cyst-transgressing access.Material and methods

Nine consecutive patients with renal stones (>20 mm) and a solitary Bosniak I cyst underwent single-tract PCNL. A specific non-cyst-transgressing puncture was used. Following stone clearance, the cyst wall was identified via combined endoscopic and ultrasonographic guidance and incised intrarenally to create a ≥1 cm window.Results

All procedures were completed with a single tract (median operative time 50 minutes). Stone-free status was achieved in 100% (9/9). Marsupialization succeeded in 8/9 patients; one case with a thick-walled cyst identified intraoperatively was managed by aspiration only. No Clavien-Dindo grade II or higher complications occurred. At 6 months, median cyst diameter decreased by 66% (from 5.6 cm to 1.9 cm), with complete symptom resolution.Conclusions

Simultaneous single-tract PCNL and intrarenal marsupialization via non-cyst-transgressing access is a feasible and safe technique. It eliminates the risk of retroperitoneal extravasation inherent to cyst-transgressing approaches. Careful patient selection, particularly regarding cyst wall thickness, is essential.

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Cite

BibTeX RIS

BibTeX

@article{nguyen2026simultaneous,
  title = {{Simultaneous single-tract percutaneous nephrolithotomy and intrarenal laser marsupialization via non-cyst-transgressing access: A pilot case series.}},
  author = {Huy-Hoang Nguyen and Ngoc-Son Do and Van-Hung Le},
  journal = {Central European journal of urology},
  year = {2026},
  month = may,
  doi = {10.5173/ceju.2026.0030},
  url = {https://europepmc.org/article/MED/42904081},
  note = {CC BY-NC-SA},
}

RIS

TY  - JOUR
TI  - Simultaneous single-tract percutaneous nephrolithotomy and intrarenal laser marsupialization via non-cyst-transgressing access: A pilot case series.
AU  - Huy-Hoang Nguyen
AU  - Ngoc-Son Do
AU  - Van-Hung Le
PY  - 2026
DA  - 2026/05/15
JO  - Central European journal of urology
DO  - 10.5173/ceju.2026.0030
UR  - https://europepmc.org/article/MED/42904081
AB  - Introduction  Ipsilateral renal stones and simple cysts usually require separate procedures or risk urinary extravasation with cyst-transgressing percutaneous techniques. This pilot study evaluated the safety and feasibility of single-tract percutaneous nephrolithotomy (PCNL) combined with intrarenal holmium:YAG laser marsupialization via a non-cyst-transgressing access.Material and methods  Nine consecutive patients with renal stones (>20 mm) and a solitary Bosniak I cyst underwent single-tract PCNL. A specific non-cyst-transgressing puncture was used. Following stone clearance, the cyst wall was identified via combined endoscopic and ultrasonographic guidance and incised intrarenally to create a ≥1 cm window.Results  All procedures were completed with a single tract (median operative time 50 minutes). Stone-free status was achieved in 100% (9/9). Marsupialization succeeded in 8/9 patients; one case with a thick-walled cyst identified intraoperatively was managed by aspiration only. No Clavien-Dindo grade II or higher complications occurred. At 6 months, median cyst diameter decreased by 66% (from 5.6 cm to 1.9 cm), with complete symptom resolution.Conclusions  Simultaneous single-tract PCNL and intrarenal marsupialization via non-cyst-transgressing access is a feasible and safe technique. It eliminates the risk of retroperitoneal extravasation inherent to cyst-transgressing approaches. Careful patient selection, particularly regarding cyst wall thickness, is essential.
SN  - 2080-4806
SN  - 2080-4873
ER  -

Abstract

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