{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:39Z","timestamp":1787008239156,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Residual stone fragments are common after percutaneous nephrolithotomy (PCNL), however, there is an unclear relationship between the presence of these residual stone fragments and the risk of unplanned stone events (USE). We investigated how the size of the largest residual stone fragment (LRSF) impacts the risk of USE post-PCNL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of PCNL between 2018 and 2022. Preoperative computed tomography of the abdomen and pelvis (CTAP) imaging and postoperative CTAP imaging were reviewed. The primary outcome was the incidence of postoperative USE, defined as stone-related emergency department visits or unplanned stone procedures. LRSF were stratified by five thresholds (no postoperative stone fragments\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      \u22650 mm, &lt;2\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      \u22652 mm, &lt;3\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      \u22653 mm, &lt;4\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      \u22654 mm, and &lt;5\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      \u22655 mm), and Cox regression was used to compare the impact of these thresholds on the risk of USE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After exclusions, we identified 138 patients who underwent PCNL during the study period; 42 patients had a USE. When applying a 4 mm threshold, 52% of patients with LRSF \u22654 mm experienced USE\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      21% with LRSF &lt;4 mm (log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0004); similarly, with a 5 mm threshold, 62.5% with LRSF \u22655 mm had such events compared with 21% with LRSF &lt;5 mm (log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.00001). A larger LRSF was associated with a greater risk of having a USE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>After PCNL, larger residual stone fragments, particularly those \u22654 mm, are associated with an increased risk of USE. These results demonstrate the value of identifying residual fragments in predicting USE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2024.0435","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T11:25:27Z","timestamp":1729855527000},"page":"1380-1386","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Residual Stone Fragments on Risk of Unplanned Stone Events Following Percutaneous Nephrolithotomy"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-3823","authenticated-orcid":false,"given":"Denzel","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaela","family":"Mali","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Carlisi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."},{"name":"Department of Surgery, University of Connecticut Health, Farmington, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Doersch","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2546-5264","authenticated-orcid":false,"given":"Scott O.","family":"Quarrier","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Rochester Medical Center, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,1]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000002331"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2021.10.008"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.05.090"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013445.pub2"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2014.0057"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0618"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-04774-z"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.06.049"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0561"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000001836"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-022-01378-3"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1590\/s1677-5538.Ibju.2018.0819"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2020.03.014"},{"issue":"11","key":"e_1_3_8_15_2","first-page":"21664","article-title":"Medium-term follow-up of clinically insignificant residual fragments after minimal invasive percutaneous nephrolithotomy: Prognostic features and risk factors","volume":"8","author":"Li X","year":"2015","unstructured":"Li X, , He L, , Li J, , Duan Z, , Gao Z, , Liu L. 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