Outcome of percutaneous nephrolithotomy.
OBJECTIVE
To assess the implementation of Percutaneous Nephrolithotomy (PCNL) in renal stone management and evaluate the factors for efficacy and safety of PCNL.


METHODS
Case series.


METHODS
Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011.


METHODS
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.


CONCLUSIONS
Percutaneous nephrolithotomy (PCNL) has a good success rate. There is minimal blood loss, and few major complications.
Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre, Karachi.
Shahzad
S
Ali
Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre, Karachi.
Naresh
N
Kumar
Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre, Karachi.
Umer
U
Baloch
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult