title: Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy.
abstract: In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success.
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey. md.farukozgor@yahoo.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Kucuktopcu
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Sarılar
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Toptas
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Abdulmuttalip
authors.initials: A
authors.lastname: Simsek
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Zafer Gokhan
authors.initials: ZG
authors.lastname: Gurbuz
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Akbulut
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Ahmet Yaser
authors.initials: AY
authors.lastname: Muslumanoglu
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D012086:Reoperation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: Kidney stone; Open renal surgery; Percutaneous nephrolithotomy