Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi

Abstract

PurposeTo compare the efficacy of percutaneous nephrolithotomy (PCNL) as a primary procedure of patients following previous open surgery or post percutaneous nephrolithotomy (PCNL) for renal calculi.Materials and MethodsThe medical records of 367 patients who underwent PCNL by a single surgeon from January 2008 to December 2013 were reviewed retrospectively. All patients were divided into 3 Groups. Group-1 (n=232) included patients with no history of ipsilateral open stone surgery. Group 2 (n=86) patients had undergone one or more open stone surgeries before PCNL, patients with failed or recurrence following PCNL were placed in Group-3 (n=49). The demographic data, operation duration, stone free rate (SFR), number of attempts to access the collecting system and intra operative and postoperative complications between the three Groups were compared.ResultsThere was no difference in sex, Body Mass Index (BMI), stone burden and laterality among the three Groups. Operation time was significantly less in first Group, while there was a statistically significant difference in operation duration between second and third Groups (p<0.05). The number of attempts to enter the collecting system was lower in the first Group in comparison to other two Groups (p<0.5). There was no significant differences among three groups in stone free rate. Intra operative and postoperative complications were slightly more frequent in Groups 2 and 3. Mortality occurred in 1 patient with colon perforation in Group-2.ConclusionOur study demonstrated that PCNL can be performed in patients even as secondary procedure without further complications.

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

“…With the help of newly developed high-pressure balloons, assistance of fascial dilators, or by mechanical dilators, difficulty in establishing access may be overcomed 28 . In some other studies, it had been reported that open stone surgery can increase PCNL failure rate 31 , while others showed that previous open stone surgery does not affect PCNL outcome 32– 34 .…”

Percutaneous nephrolithotomy in anesthesia view: A 3-year experience of a referral hospital

“…The mean duration of surgery was 106.34±35.69 minutes in our PNL patients. Reddy et al [24] reported a mean duration of 2.9±0.9 hours (range: 1.5-6 hours) in these procedures. Using an ultrasonographic approach on the renal calyceal system also decreases the operation time.…”

“…The lungs and the pleura are the most frequently injured organs during PNL, with a ratio of between 2% and 8%. [24,25] In cases of regional anesthesia, during the supracostal puncture, the patient must follow verbal commands and continue breathing. This requires good patient cooperation.…”

“…In our patients, 1 patient (0.19%) had pleural effusion and 1 patient (0.19%) had hemopneumothorax managed with a chest drain, a significantly smaller ratio than that seen in other reports. [24,25] Another source of conflicting data is the effect of anesthesia type on fluoroscopic screening time. Our mean fluoroscopic screening time was 23.20±1.45 seconds under general anesthesia.…”

Overview Percutaneous Nephrolithotomy - A Case Report 32-Year-Old Male with Renal Calculi

“…Management of patients suffering from urinary tract calculi is a health care problem because of its prevalence and recurrence [1]. Minimally invasive treatments, such as percutaneous nephrolithotomy (PCNL), non-invasive extracorporeal shock wave lithotripsy (ESWL), and laparoscopy procedures have almost completely replaced open surgery in the management of the urinary stone disease [2,3].…”