{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:50:40Z","timestamp":1782737440417,"version":"3.54.5"},"reference-count":21,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Introduction: Residual stones after percutaneous nephrolithotomy (PCNL) remain a major clinical challenge, particularly in patients with large or complex calculi. Second-look PCNL offers a minimally invasive option for achieving complete stone clearance; however, realworld data on outcomes, timing, and predictive factors are limited.\nMaterials and methods: We retrospectively analyzed 72 patients who underwent second-look mini-PCNL at a high-volume tertiary center. Perioperative parameters were compared between procedures and between stone-free and residual stone groups. Stone-free status was defined as the absence of residual fragments \u2265 4 mm on non-contrast computed tomography. Outcomes of early (same admission) versus delayed second-look PCNL were evaluated.\nResults: Most patients had high stone complexity, with 79.17% classified as Guy\u2019s Stone Score grade 4. The overall stone-free rate after second-look PCNL was 55.56%. Multivariate analysis identified the presence of more than five stones as the only independent predictor of residual fragments (OR 6.49, 95% CI 1.65- 25.52; p = 0.007). Operative time and complication rates were comparable between procedures, while early re-intervention significantly reduced hospitalization duration and antibiotic use (both p &lt; 0.01).\nConclusions: Despite a modest SFR, second-look PCNL is a safe and effective strategy for managing residual stones. Early reintervention during the same admission improves recovery and optimizes resource utilization.<\/jats:p>","DOI":"10.4081\/aiua.2026.15512","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T08:28:28Z","timestamp":1779265708000},"source":"Crossref","is-referenced-by-count":0,"title":["Safety and outcomes of second-look percutaneous nephrolithotomy for complex renal stones: a retrospective study"],"prefix":"10.4081","volume":"98","author":[{"given":"Anh Toan","family":"Do","sequence":"first","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"},{"name":"Department of Urology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngoc Thai","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"},{"name":"Department of Urology, Binh Dan Hospital, Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinnosuke","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phan Nhat Duy","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dao Thuan","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"},{"name":"Department of Urology, Binh Dan Hospital, Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huynh Dang Khoa","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan Thai","family":"Ngo","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"231175","doi-asserted-by":"crossref","unstructured":"1. Zhu C, Wang DQ, Zi H, et al. Epidemiological trends of urinary tract infections, urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019. Mil Med Res. 2021;8(1):64.","DOI":"10.1186\/s40779-021-00359-8"},{"key":"231176","doi-asserted-by":"crossref","unstructured":"2. Taguchi K, Cho SY, Ng AC, et al. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol. 2019;26(7):688-709.","DOI":"10.1111\/iju.13957"},{"key":"231177","doi-asserted-by":"crossref","unstructured":"3. Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association\/Endourological Society Guideline, PART I. J Urol. 2016;196(4):1153-1160.","DOI":"10.1016\/j.juro.2016.05.090"},{"key":"231178","unstructured":"4. A. Skolarikos (Chair), H. Jung, A. Neisius, et al. EAU Guidelines on Urolithiasis. EAU Guidelines 2025. 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Fate of residual stones after percutaneous nephrolithotomy: a critical analysis. J Endourol. 2009;23(3):399-403.","DOI":"10.1089\/end.2008.0217"},{"key":"231183","doi-asserted-by":"crossref","unstructured":"9. Emmott AS, Brotherhood HL, Paterson RF, Lange D, Chew BH. Complications, Re-Intervention Rates, and Natural History of Residual Stone Fragments After Percutaneous Nephrolithotomy. J Endourol. 2018;32(1):28-32.","DOI":"10.1089\/end.2017.0618"},{"key":"231184","doi-asserted-by":"crossref","unstructured":"10. Degirmenci T, Bozkurt IH, Celik S, Yarimoglu S, Basmaci I, Sefik E. Does leaving residual fragments after percutaneous nephrolithotomy in patients with positive stone culture and\/or renal pelvic urine culture increase the risk of infectious complications?. Urolithiasis. 2019;47(4):371-375.","DOI":"10.1007\/s00240-018-1063-9"},{"key":"231185","doi-asserted-by":"crossref","unstructured":"11. Danilovic A, Torricelli FCM, Marchini GS, et al. Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery. J Endourol. 2021;35(5):609-614.","DOI":"10.1089\/end.2020.0868"},{"key":"231186","doi-asserted-by":"crossref","unstructured":"12. Skolarikos A, Papatsoris AG. Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments. J Endourol. 2009;23(10):1751-1755.","DOI":"10.1089\/end.2009.1546"},{"key":"231187","doi-asserted-by":"crossref","unstructured":"13. Preminger GM, Assimos DG, Lingeman JE, et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005;173(6):1991-2000.","DOI":"10.1097\/01.ju.0000161171.67806.2a"},{"key":"231188","doi-asserted-by":"crossref","unstructured":"14. Ito H, Kawahara T, Terao H, et al. Evaluation of preoperative measurement of stone surface area as a predictor of stone-free status after combined ureteroscopy with holmium laser lithotripsy: a single-center experience. J Endourol. 2013;27(6):715-721.","DOI":"10.1089\/end.2012.0548"},{"key":"231189","doi-asserted-by":"crossref","unstructured":"15. de la Rosette JJ, Opondo D, Daels FP, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012;62(2):246-255.","DOI":"10.1016\/j.eururo.2012.03.055"},{"key":"231190","doi-asserted-by":"crossref","unstructured":"16. \u00c7avdar OF, Aydin A, Tokas T, et al. Residual stone fragments: systematic review of definitions, diagnostic standards. World J Urol. 2025;43(1):194.","DOI":"10.1007\/s00345-025-05572-x"},{"key":"231191","doi-asserted-by":"crossref","unstructured":"17. Jiao B, Luo Z, Huang T, Zhang G, Yu J. A systematic review and meta-analysis of minimally invasive vs. standard percutaneous nephrolithotomy in the surgical management of renal stones. Exp Ther Med. 2021;21(3):213.","DOI":"10.3892\/etm.2021.9645"},{"key":"231192","doi-asserted-by":"crossref","unstructured":"18. Akdogan N, Zubaroglu M, Ar\u0131kan MG, Yilmaz IO, Deger M. The impact of chronic kidney disease stages and CROES AND GSS scores on stone free rate in kidney stones. BMC Urol. 2025;25(1):65. Published 2025 Mar 31.","DOI":"10.1186\/s12894-025-01757-z"},{"key":"231193","doi-asserted-by":"crossref","unstructured":"19. Dai JC, Trivedi H, Kommidi V, Antonelli JA, Pearle MS, Johnson BA. Predictors of Persistent Residual Stones After Second Look Percutaneous Nephrolithotomy. J Endourol. 2025;39(1):26-33.","DOI":"10.1089\/end.2024.0610"},{"key":"231194","doi-asserted-by":"crossref","unstructured":"20. G\u00fcc\u00fck A, Kemahl\u0131 E, \u00dcyet\u00fcrk U, Tuygun C, Y\u0131ld\u0131z M, Metin A. 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Urology. 2017;99:27-32.","DOI":"10.1016\/j.urology.2016.06.074"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15512\/14095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15512\/14095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:42:55Z","timestamp":1782736975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,29]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15512","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,20]]}}}