Percutaneous Nephrolithotomy: A Single Center Experience of 610 Cases

Abstract

Purpose: We performed this study to evaluate the outcomes and complications of percutaneous nephrolithotomy (PCNL) at a single institute with a large series. Materials and Methods:We reviewed the medical records of 610 patients who underwent PCNL between March 1995 and June 2008 for staghorn calculi in 139 (22.8%), partial staghorn calculi in 104 (17.0%), renal pelvis stone in 222 (36.4%), proximal ureter calculi in 60 (9.8%), and calculi within a caliceal diverticulum in 85 (13.9%) patients. Stone-free status was defined as no visible residual calcification or remnant calcification smaller than 4 mm in diameter (clinically insignificant residual fragment) on a plain KUB (X-ray examination of the kidney, ureter, and bladder) image. Characteristics of the stones, operation time, stone-free rate, and complications were evaluated. Results: Initial stone burden was 665.9±600.6 mm 2 . Average operation time was 103.2±58.6 minutes. The mean hospital stay was 7.9 days. The stonefree rate was 84.9%, and ancillary procedures were required in 66 patients (10.8%), including 34 (5.6%) second-look PCNL and 26 (4.3%) ureteroscopic procedures. In the univariate analysis for prediction of stone-free rate, hydronephrosis, stone type, stone composition, and stone burden were significant prognostic factors. In the multivariate analysis, initial stone burden was the only independent factor affecting the stone-free rate. Complications were found in 95 patients (16.1%), 5 (0.8%) of whom needed embolization due to bleeding and 23 (3.8%) of whom showed pleural complications. Conclusions: PCNL is an effective method for the treatment of staghorn, large calyceal, and some upper ureteral stones with acceptable complication rates. (

Complications of Percutaneous Nephrolithotomy Classified by the Modified Clavien Grading System: A Single Center's Experience over 16 Years

“…The most recent Korean report of PCNL performed in single large center was published in 2009 by Kwon et al [ 13 ]. In their retrospective report comprising 610 patients, the initial stone-free rate was 57.6% and the overall stone-free rate was 84.9%.…”

Percutaneous Nephrolithotomy: Comparison of the Efficacies and Feasibilities of Regional and General Anesthesia

“…In addition, according to a large-scale study, initial and overall stone-free rates were 69.9% and 88.8%, respectively [ 27 ], and another study conducted on 610 patients found corresponding rates of 57.6% and 84.9%, respectively [ 28 ]. In the present study, values were 68.8% and 80.5% in the regional anesthesia group and 42.9% and 71.4% in the general anesthesia group, which were relatively low and did not represent a significant intergroup difference.…”