Literature DB >> 18930485

Prognostic factors and percutaneous nephrolithotomy morbidity: a multivariate analysis of a contemporary series using the Clavien classification.

J J M C H de la Rosette1, J Rioja Zuazu, P Tsakiris, A M Elsakka, J J Zudaire, M P Laguna, Th M de Reijke.   

Abstract

PURPOSE: We stratified factors affecting treatment morbidity, compared the outcomes of percutaneous nephrolithotomy procedures from a single department and provided evidence of treatment benefits when percutaneous nephrolithotomy is performed in an expert setting.
MATERIALS AND METHODS: Since the department became a dedicated endourological center in 2002 we grouped all percutaneous nephrolithotomy procedures into those performed before 2002 (group 1) and after 2002 (group 2). The modified Clavien classification was used to score morbidity. Independent variables with an influence on complications were studied including stone size, operating time, operative complications, dilation device, urine culture, group allocation and lithotripsy device. Contingency and logistic regression were used for univariate and multivariate analysis.
RESULTS: Of the 244 percutaneous nephrolithotomy procedures 68 comprised group 1 and 176 formed group 2. Statistical preoperative differences were patient age, the use of anticoagulants and positive urinary cultures. Group 1 had a complication rate of 56.8% and group 2 had a complication rate of 37.2%. There were significant differences between the groups (p = 0.007). Almost all complications were grade 1 to 2. On univariate analysis the influence variables were urine culture (OR 1.69), group allocation (OR 2.20), stone size (OR 2.28), dilation device (OR 4.8), lithotripsy device (OR 1.22), perioperative complications (OR 2.83) and surgical time (OR 1.87). On multivariate analysis the independent factors in the complicated outcome were stone size (OR 1.25), type of lithotripsy device (OR 1.35) and incidence of perioperative complications (OR 3.71).
CONCLUSIONS: The dedicated setting for percutaneous nephrolithotomy at our center resulted in decreased operative time, more uneventful procedures and decreased hospitalization time. The modified Clavien morbidity score is a reliable tool for more objective outcome comparisons after renal stone treatment.

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Year:  2008        PMID: 18930485     DOI: 10.1016/j.juro.2008.08.025

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  24 in total

1.  Clavien classification in urology: Is there concordance among post-graduate trainees and attending urologists?

Authors:  Mohamed A Elkoushy; Murilo A Luz; Tarik Benidir; Saad Aldousari; Armen G Aprikian; Sero Andonian
Journal:  Can Urol Assoc J       Date:  2013 May-Jun       Impact factor: 1.862

Review 2.  Percutaneous nephrolithotomy: technique.

Authors:  Thomas Knoll; Francisco Daels; Janak Desai; Andras Hoznek; Bodo Knudsen; Emanuele Montanari; Cesare Scoffone; Andreas Skolarikos; Keiichi Tozawa
Journal:  World J Urol       Date:  2017-01-25       Impact factor: 4.226

3.  Prediction of stone-free status and complication rates after tubeless percutaneous nephrolithotomy: a comparative and retrospective study using three stone-scoring systems and preoperative parameters.

Authors:  Sae Woong Choi; Woong Jin Bae; U-Syn Ha; Sung-Hoo Hong; Ji Youl Lee; Sae Woong Kim; Hyuk Jin Cho
Journal:  World J Urol       Date:  2016-07-12       Impact factor: 4.226

4.  Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?

Authors:  Ramazan Kocaaslan; Abdulkadir Tepeler; Ibrahim Buldu; Muhammed Tosun; Mehmet Mazhar Utangac; Tolga Karakan; Ekrem Ozyuvali; Namik Kemal Hatipoglu; Ali Unsal; Kemal Sarica
Journal:  Urolithiasis       Date:  2016-07-12       Impact factor: 3.436

5.  Costs variations for percutaneous nephrolithotomy in the U.S. from 2003-2015: A contemporary analysis of an all-payer discharge database.

Authors:  Jeffrey J Leow; Anne-Sophie Valiquette; Benjamin I Chung; Steven L Chang; Quoc-Dien Trinh; Rus Korets; Naeem Bhojani
Journal:  Can Urol Assoc J       Date:  2018-06-19       Impact factor: 1.862

6.  Evaluation of stone-free rate using Guy's Stone Score and assessment of complications using modified Clavien grading system for percutaneous nephro-lithotomy.

Authors:  Rajan Kumar Sinha; Subhabrata Mukherjee; Tarun Jindal; Pramod Kumar Sharma; Barun Saha; Nilanjan Mitra; Jay Kumar; Chandranath Mukhopadhyay; Nabankur Ghosh; Mir Reza Kamal; Soumendra Nath Mandal; Dilip Karmakar
Journal:  Urolithiasis       Date:  2015-04-08       Impact factor: 3.436

7.  Flexible ureterorenoscopy versus miniaturized PNL for solitary renal calculi of 10-30 mm size.

Authors:  Thomas Knoll; Jan Peter Jessen; Patrick Honeck; Gunnar Wendt-Nordahl
Journal:  World J Urol       Date:  2011-10-29       Impact factor: 4.226

8.  Diabetes, a risk factor for both infectious and major complications after percutaneous nephrolithotomy.

Authors:  Wei Wei; Jiangyong Leng; Hongxiang Shao; Weidong Wang
Journal:  Int J Clin Exp Med       Date:  2015-09-15

9.  Time-dependent oxidative stress effects of percutaneous nephrolithotomy.

Authors:  Haluk Söylemez; Yaşar Bozkurt; Necmettin Penbegül; Ahmet Ali Sancaktutar; Bülent Altunoluk; Murat Atar; Osman Evliyaoglu; Mehmet Nuri Bodakci; Namık Kemal Hatipoglu
Journal:  Urolithiasis       Date:  2012-12-21       Impact factor: 3.436

10.  A case of micro-percutaneous nephrolithotomy with macro complication.

Authors:  Onur Dede; Mazhar Utangaç; Mansur Dağguli; Namık Kemal Hatipoğlu; Ahmet Ali Sancaktutar; Mehmet Nuri Bodakçı
Journal:  Turk J Urol       Date:  2015-02-18
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