Ambulatory Percutaneous Nephrolithotomy: What Is the Rate of Readmission?

Abstract

Ambulatory PCNL is safe in highly selected patients with a stone-free rate of 90% and readmission rate of 4%. Prospective studies comparing standard PCNL with ambulatory PCNL are warranted.

Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy

“…In addition, they examined the association between the risk of complication and patients' characteristics including the age at admission, sex, and comorbidities using an updated version of the Charlson comorbidity score. Recently, Beiko et al [11] reported their ambulatory PNL series including the assessment of rates of emergency department (ED) visits and readmissions postambulatory PNL. The authors noted a rate of 12 % for returning to ED and 4 % for readmission rate.…”

“…Complications occurred at a rate of 6.44 % in the 2010, the USA spent $17.5 billion on HR rates [7], rendering it essential to minimize such events. However, to date, few studies have addressed either the frequency of HR and/ or unplanned care or factors potentially predictive of such needs, after urological surgical procedures [8][9][10][11].…”

Getting started with ambulatory PCNL: A CanMEDS perspective

“…Because of the strict inclusion criteria, our experience to date is based on a small combined experience of 70 patients to date, the first 50 of which were reported in our initial multi-institutional publication. 8 However, we are constantly re-evaluating our results and expanding the inclusion criteria as we gain more experience. We are confident that these lessons can be used as a guide to help other urologists who are interested in performing aPCNL.…”

“…4 Despite Preminger's initial case series on ambulatory percutaneous nephrolithotomy (aPCNL) from the 1980's, 5 patients undergoing PCNL have traditionally been admitted postoperatively. Recently, Canada has been pioneering the shift to aPCNL, with Queen's and McGill universities having reported independent small case series, 6,7 as well as a multi-institutional study 8 that showed this approach to be safe and effective in 50 highly selected patients, with an acceptable readmission rate of 4%. Additionally, Abbott and colleagues reported their aPCNL experience in over 60 patients.…”

S’initier à la néphrolithotomie percutanée ambulatoire : 10 leçons inspirées du cadre conceptuel du CanMEDS

“…En raison des critères d'inclusion très rigoureux qui sont en place, notre expérience repose jusqu'ici sur un groupe limité de 70 patients, dont les 50 premiers ont fait l'objet de notre première publication pluri-institutionnelle 8 . Cependant, nous réévaluons sans cesse nos résultats et élargissons les critères d'inclusion à mesure que nous prenons de l'expé-rience.…”