Factors affecting success and complication of percutaneous nephrolithotomy

Abstract

AimPercutaneous nephrolithotomy (PNL) is the first choice renal stones especially larger than 2 cm, and high success rates can be achieved after PNL. But several severe complications may be occurred. In this study, factors which affect the success rate and complications were investigated.MethodsBetween July 2004 and August 2007, 176 patients (102 men/74 women) underwent PNL operation. Because of the bilateral renal stones PNL was performed in two separate sessions of 9 patients. Percutaneous ac-cess was doing in prone position. Factors affecting the success and compli-cation data were collected.ResultsMean age was 47.6 ± 10,7 (17%uFFFD76 year, median=47). Complete success rate was detected 77.8% with the di-rect X-rays taken in the first postoperative day. The success rate was up to 87% after the additional post-treatment therapy. Success rates were 83.1% for complex stones and 89.4% for simple stones (P < /em> < .001). Stone size and location, percutaneous access number, surgical experience and the need for additional treatment as factors affecting the success rates were found to be statistically significant. The major and in minor complications were obser-ved in 14.1% and 17.8%, respectively. One patient died in postoperative peri-od. Major complications exitus (n: 1), bleeding requiring blood transfusion (n: 15), adjacent organ injury (n:2), Malekot catheter do not leave the kidney (n: 2) and one patient had non-functional kidney. Presence of great stone bur-den and complex stones, multiple access and access location as factors af-fecting the complications rates were found to be statistically significant. ConclusionStone size and location, access number, the need for additional tre-atment and surgical experience can be listed as factors affecting the success of the PNL process. Especially in experienced hands it is possible to get good results with lower complication rates.

Keywords

percutaneous nephrolithotomysuccesscomplication

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