Patrick Jones1, Grace Bennett2, Alexios Dosis2, Amelia Pietropaolo1, Robert Geraghty1, Omar Aboumarzouk3, Andreas Skolarikos4, Bhaskar K Somani5. 1. Department of Urology, University Hospital Southampton, Southampton, UK. 2. Department of Urology, Royal Preston Hospital, Preston, UK. 3. Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK; EAU Young Academic Urologists (YAU) Endourology Group, Arnhem, The Netherlands. 4. 2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece; European Association of Uro-technology (ESUT), Arnhem, The Netherlands. 5. Department of Urology, University Hospital Southampton, Southampton, UK; EAU Young Academic Urologists (YAU) Endourology Group, Arnhem, The Netherlands; European Association of Uro-technology (ESUT), Arnhem, The Netherlands. Electronic address: b.k.somani@soton.ac.uk.
Abstract
CONTEXT: Day case or ambulatory percutaneous nephrolithotomy (PCNL) has risen over the last few years with the aim of discharging patients within 24h. OBJECTIVE: We perform a systematic review of literature to evaluate the outcomes of day-case PCNL surgery. EVIDENCE ACQUISITION: A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science Direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. All studies in the English language reporting on PCNL patients discharged within 24h were included. EVIDENCE SYNTHESIS: Based on the literature search of 97 articles, nine (502 patients) met the inclusion criteria (mean age: 47 yr), with a mean stone size of 20.5mm. The mean operating time was 66min, and over a mean hospital stay of 17.5h, the stone-free rate was 95%. The overall complication rate was 13.5%; the vast majority of these complications were Clavien I-II complications, with a readmission rate of 3%. CONCLUSIONS: Day-case PCNL is a safe and feasible strategy in carefully selected cases. However, for its success, detailed planning and adherence to surgical protocol are paramount with strict criteria for inpatient admission and a thorough follow-up plan. PATIENT SUMMARY: Day-case percutaneous nephrolithotomy procedure seems to be a safe procedure with good outcomes, and low risk of complications and readmissions. Detailed preoperative protocol and planning are paramount, with indications for inpatient admission as well as a thorough follow-up plan.
CONTEXT: Day case or ambulatory percutaneous nephrolithotomy (PCNL) has risen over the last few years with the aim of discharging patients within 24h. OBJECTIVE: We perform a systematic review of literature to evaluate the outcomes of day-case PCNL surgery. EVIDENCE ACQUISITION: A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science Direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. All studies in the English language reporting on PCNL patients discharged within 24h were included. EVIDENCE SYNTHESIS: Based on the literature search of 97 articles, nine (502 patients) met the inclusion criteria (mean age: 47 yr), with a mean stone size of 20.5mm. The mean operating time was 66min, and over a mean hospital stay of 17.5h, the stone-free rate was 95%. The overall complication rate was 13.5%; the vast majority of these complications were Clavien I-II complications, with a readmission rate of 3%. CONCLUSIONS: Day-case PCNL is a safe and feasible strategy in carefully selected cases. However, for its success, detailed planning and adherence to surgical protocol are paramount with strict criteria for inpatient admission and a thorough follow-up plan. PATIENT SUMMARY: Day-case percutaneous nephrolithotomy procedure seems to be a safe procedure with good outcomes, and low risk of complications and readmissions. Detailed preoperative protocol and planning are paramount, with indications for inpatient admission as well as a thorough follow-up plan.
Authors: Gregory William Hosier; Kashif Visram; Thomas McGregor; Stephen Steele; Naji J Touma; Darren Beiko Journal: Can Urol Assoc J Date: 2022-04 Impact factor: 2.052