OBJECTIVE: To assess the implementation of Percutaneous Nephrolithotomy (PCNL) in renal stone management and evaluate the factors for efficacy and safety of PCNL. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011. METHODOLOGY: Patients aged above 12 years of age, irrespective of gender with normal renal function, mean stone size > 2 cm, lower pole stones > 1 cm, and ESWL failure were selected. After the procedure, on the first postoperative day, a plain abdominal radiograph was obtained to verify stone clearance. A nephrostomy tube was clamped overnight and subsequently removed when no residual stone which needs second sitting was seen. RESULTS: In 175 patients, 62.86% (n=110) were male and the mean age was 35 ± 9.56 years. One hundred and seventeen (66.85%) patients were primarily stone free and 13.71% (n=24) patients needed a second look procedure, thus, a total of 80.57% (n=141) patients were stone free in the same admission. Complications included failure in 4.0% (n=7) patients, bleeding in 8.57% (n=15) patients, a small residual stone in 15.43% (n=27) patients; and puncture site pain almost in every patient. Transient fever occurred in 55.43% (n=97) patients, urinary leakage in 8.57% (n=15) patients, urinary tract infections in 5.14% (n=9) patients, ureteric colic in 3.43% (n=6) patients, colonic injury in 0.57% (n=1) patient; and nephrectomy was required in 0.57% (n=1) patient due to severe bleeding. One patient (0.57%) expired due to anaesthesia complications. CONCLUSION: Percutaneous nephrolithotomy (PCNL) has a good success rate. There is minimal blood loss, and few major complications.
OBJECTIVE: To assess the implementation of Percutaneous Nephrolithotomy (PCNL) in renal stone management and evaluate the factors for efficacy and safety of PCNL. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011. METHODOLOGY:Patients aged above 12 years of age, irrespective of gender with normal renal function, mean stone size > 2 cm, lower pole stones > 1 cm, and ESWL failure were selected. After the procedure, on the first postoperative day, a plain abdominal radiograph was obtained to verify stone clearance. A nephrostomy tube was clamped overnight and subsequently removed when no residual stone which needs second sitting was seen. RESULTS: In 175 patients, 62.86% (n=110) were male and the mean age was 35 ± 9.56 years. One hundred and seventeen (66.85%) patients were primarily stone free and 13.71% (n=24) patients needed a second look procedure, thus, a total of 80.57% (n=141) patients were stone free in the same admission. Complications included failure in 4.0% (n=7) patients, bleeding in 8.57% (n=15) patients, a small residual stone in 15.43% (n=27) patients; and puncture site pain almost in every patient. Transient fever occurred in 55.43% (n=97) patients, urinary leakage in 8.57% (n=15) patients, urinary tract infections in 5.14% (n=9) patients, ureteric colic in 3.43% (n=6) patients, colonic injury in 0.57% (n=1) patient; and nephrectomy was required in 0.57% (n=1) patient due to severe bleeding. One patient (0.57%) expired due to anaesthesia complications. CONCLUSION: Percutaneous nephrolithotomy (PCNL) has a good success rate. There is minimal blood loss, and few major complications.
Authors: Ahmed M Harraz; Yasser Osman; Ahmed R El-Nahas; Amr A Elsawy; Islam Fakhreldin; Osama Mahmoud; Ahmed El-Assmy; Ahmed A Shokeir Journal: World J Urol Date: 2016-12-24 Impact factor: 4.226