Is Postoperative Routine Thoracic Imaging Necessary to Detect Thoracic Complications in Patients Undergoing Supracostal Mini Percutaneous Nephrolithotomy (M-pcnl) Surgery?

Abstract

Purpose This study aimed to assess the necessity of routine postoperative thoracic imaging for detecting pulmonary complications in patients undergoing supracostal mini percutaneous nephrolithotomy (m-pcnl) surgery. Materials and Methods Retrospective analysis was conducted on data from patients who underwent supracostal m-pcnl between 2017 and 2022 in a tertiary center. Excluding patients under 18, with kidney/skeletal anomalies, or active thoracic disease, 112 eligible patients were included. Patients were divided into two groups: those with routine postoperative chest X-rays (CXR) (Group 1, n = 40) and those without (Group 2, n = 72). Complications and operative data were compared between groups. Results Mean ages were 44.3 ± 11.4 (Group 1) and 42.6 ± 13.1 years (Group 2), with no significant difference (p = 0.102). Stone sizes were 30.8 ± 8.6 mm (Group 1) and 24.8 ± 8.4 mm (Group 2), also not significantly different (p = 0.313). High fever occurred in 10% of Group 1 and 4% of Group 2 (p = 0.246). Minimal effusion was found in 10% of Group 1, with no treatment due to lack of symptoms. However, subsequent CXR revealed hydropneumothorax in 2.5% of cases, necessitating thoracic tube insertion. In Group 2, 5% developed postoperative respiratory symptoms, with significant pneumothorax in 1.3%, requiring thoracic tube placement. Thoracic tube insertion rates did not significantly differ between groups (Group 1: 2.5% vs Group 2: 1.3%, p = 0.671). Conclusion Routine postoperative thoracic imaging did not show added benefit in detecting pulmonary complications post-supracostal m-pcnl.