institution in 56.7% of cases (46 patients), to the patient in Jessica Chan 38.2% of cases (31 patients), and in 4.9% of cases (4 patients) it could not be defined.CONCLUSIONS: Implementation of multiple safeguards may be more effective than using any single method. The use of a centralized computerized registry, in addition to the written information regarding stents and providing patients with wristbands at discharge, with their follow up appointment, deadline date for stent withdrawal, and department telephone contacts, address the problem on multiple fronts and this protocol is under implementation in all institutions.
All cases were reviewed and demographic data and case details were analyzed.RESULTS: 1000 consecutive aPNL cases were reviewed, identifying 488 men and 512 women, 460 right side and 535 left, mean age 57 years (15-86), mean BMI 30 (15-49), mean ASA of 2.3 (1-4) and mean stone burden 31 mm (4-170), mean fluoroscopy time 84 sec (0-322). Mean OR time was 95 min (32-305) and mean treatment time was 14.9 min (1-262). Mean PACU time was 91 min (37-247). A mini-PNL (mPNL) procedure was conducted in 255 (25.5%) patients. The remaining 745 cases were standard tract size of which 449 were 30Fr and 296 were 24Fr. Stone free rate was 83%. Thirty nine patients had complications ranging from Clavien II-IVa, of which 15 were hospital transfers.CONCLUSIONS: These consecutive 1000 cases may serve as a landmark series demonstrating the feasibility of aPNL. Transitioning PNL to an ambulatory setting is a paradigm shift in the treatment of complex kidney stones. 39 patients experienced complications of Clavien II or higher. Each complication that occurred was managed in an appropriate fashion and the site of service did not lead to an alteration in the outcomes of the adverse events. With an experienced surgeon, well trained operative team and with modifications to the procedure focusing on post-operative pain control, PNL can be safely and effectively performed in a free standing ASC. 1. Davalos JG,
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