Risk Factors for Postoperative Complications of Percutaneous Nephrolithotomy at a Tertiary Referral Center

Olvera‐Posada, Daniel; Tailly, Thomas; Alenezi, Husain; Violette, Philippe D.; Nott, Linda; Denstedt, John D.; Razvi, Hassan

doi:10.1016/j.juro.2015.06.095

Cited by 57 publications

(34 citation statements)

References 25 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, durations of operation as reported in the literature vary between 61.2 ± 30.5 min and 108.75 ± 47.43 min [11–13]. Our findings are consistent with the literature.…”

Section: Discussionsupporting

confidence: 92%

The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

Karaduman

Karasu

Yılmaz

et al. 2017

Pain Research and Management

View full text Add to dashboard Cite

Objective. We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic consumption in patients who underwent percutaneous nephrolithotomy. Material and Methods. Patients aged between 18 and 65 years and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients underwent spinoepidural anesthesia. 20 mL of 0.25 percent bupivacaine + 5 mg morphine (0.5 mL), in Group P (n = 66), infiltrated the renal capsule, perinephric fat, muscles, subcutaneous tissue, and skin under fluoroscopy. In Group C (n = 64), none of the patients received a peritubal injection. In the first 24 h pain scores, time of the first analgesic demand, the mean number of analgesic demands, and postoperative complications were compared between groups. Results. The mean VAS score at postoperative 8, 12, and 24 h and dynamic VAS score at postoperative 4, 8, 12, and 24 h were significantly lower in Group P. VAS score at postoperative 4 h was not significant. Time of the first analgesic demand was significantly longer in Group P. Conclusion. Our study results suggest that peritubal infiltration of bupivacaine with morphine after percutaneous nephrolithotomy is an effective method for postoperative pain control and reduces analgesic consumption.

show abstract

“…In addition, durations of operation as reported in the literature vary between 61.2 ± 30.5 min and 108.75 ± 47.43 min [11–13]. Our findings are consistent with the literature.…”

Section: Discussionsupporting

confidence: 92%

The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

Karaduman

Karasu

Yılmaz

et al. 2017

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…PNL is a relatively safe and effective procedure for managing nephrolithiasis refractory to other treatment modalities [3]. However, various complications are associated with PNL, including extravasation, blood transfusion, hemothorax, renal rupture, injury of other organs, fever, and sepsis [6,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…In clinical practice, prediction and prevention of urosepsis are important to decrease the morbidity and mortality rates in patients undergoing PNL [3,11,13]. Potential risk factors associated with urosepsis due to PNL have been identified [4,[16][17][18][19][20], including female sex, chronic renal failure, anemia, hydronephrosis, stones ≥2.5 cm, positive preoperative urine and stone culture, positive intraoperative renal pelvis urine culture, and prolonged operative time [4,[16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Development of sudden refractory hypotension resulting from urosepsis in the post-anesthesia care unit after percutaneous nephrolithotomy for renal calculi: a case report

Koh

Kim

et al. 2019

Med Biol Sci Eng

View full text Add to dashboard Cite

Percutaneous nephrolithotomy (PNL) is a relatively safe and effective procedure for the management of nephrolithiasis but is associated with severe complications. We report the case of a 76-year-old woman who underwent PNL for renal calculi removal. Preoperative urinalysis detected a large number of white blood cells and, on culture, Escherichia coli was detected. After an uneventful recovery from general anesthesia, she developed tachycardia, high fever, severe shivering, and hypotension in the post-anesthesia care unit. She was diagnosed with urosepsis associated with PNL and was transferred to the intensive care unit. Urosepsis and refractory hypotension persisted despite meticulous fluid management and vasopressor and inotropic agent administration. On postoperative day 5, she was hemodynamically stable and was transferred to a general ward. On postoperative day 12, she was discharged without any complications. Urosepsis after PNL can be catastrophic; therefore, early detection and optimal treatment are necessary to improve the postoperative outcome. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

“…[21] Still in a separate study, a statistically significant difference was not detected between ASA risk groups,and any Clavien complication class. [22] In two separate studies performed by Toksöz et al [23] , and Nouralizadeh et al [11] the patients were divided into low (ASA I-II), and high risk (ASA III-IV) groups. According to Clavien classification, a statistically significant intergroup difference was not found regarding postoperative complications, and safe application of PNL even in high-risk patients was reported.…”

Section: Discussionmentioning

confidence: 99%

Comparison of intraoperative and postoperative complications based on ASA risks in patients who underwent percutaneous nephrolithotomy

Karakaş

Çiçekbilek

Tok

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: In this study we aimed to evaluate intraoperative and postoperative complications which developed according to pre-operative American Society of Anesthesiologists (ASA) risk criteria in patients who had undergone percutaneous nephrolithotomy (PNL). Material and methods:Five hundred and sixty patients who had undergone PNL between 2002 and 2014 were included in the study. Patients operated on the ipsilateral kidney, those with solitary kidney or the cases who had previously undergone more than one access were excluded from this study. Preoperative anesthesia risks were determined according to preoperative classification developed by ASA. Postoperative complications were evaluated using Clavien Complication Grading Scale. Results:The mean age of the cases was 47±14 years. The 57% (n=319) of the cases were male, 241 (43%) of them were female. The average indwell time of nephrostomy catheter was 2.88±1.00 (1-8), and length of hospital stay was 4.91±1.54 (2-17) days. When the cases were assessed according to ASA risk groups, intraoperative complications were observed in 9 (5.5%) ASA I, 27 (8.6%) ASA II, and 18 (22%) ASA III patients and and distribution of the patients was statistically significant (p<0.001). When intraoperative complications were evaluated one by one, intraoperative hypotension developed in ASA I (n=3; 1.8%), ASA II (n=20; 6.4%) and ASA III (n=11; 13.4%) risk groups and this distribution (p=0.002) of patients was statistically significant. When assessed according to Clavien Postoperative Scale, postoperative complications developed (p=0.053) in ASAI (n=24; 14.7%), ASA II (n=27, 8.6%) and ASA III (n=13; 15.9%) risk groups, and this distribution of the patients was not statistically significant. In postoperative complications, Grade 3a complications developed in ASA I (n=12; 7.4%), ASA II (n=19; 6%) and ASA III (n=8; 9.8%) risk groups and this distribution was not seen to be statistically significant (p=0.485). Conclusion:A statistically significant difference observed regarding intraoperative complications in the groups formed according to ASA risk criteria, on Clavien Grading scale no statistically significant difference was observed as for postoperative complications. In this context, we considered that ASA risks are major risk factors for PNL operations in terms of intraoperative complications.

show abstract

Risk Factors for Postoperative Complications of Percutaneous Nephrolithotomy at a Tertiary Referral Center

Abstract: At our center percutaneous nephrolithotomy is an excellent option for complex kidney stone management with a low overall complication rate. Older patient age and upper pole access are significantly associated with an increased risk of a major complication.

Cited by 57 publications

References 25 publications

The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

Development of sudden refractory hypotension resulting from urosepsis in the post-anesthesia care unit after percutaneous nephrolithotomy for renal calculi: a case report

Comparison of intraoperative and postoperative complications based on ASA risks in patients who underwent percutaneous nephrolithotomy

Contact Info

Product

Resources

About