title: Percutaneous nephrolithotomy in patients with solitary kidney: a critical outcome analysis.
abstract: OBJECTIVE
  To describe our experience with percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys and analyze factors that can impact on intra-operative bleeding and postoperative complications.
  
  
  METHODS
  We reviewed our stone database searching for patients with solitary kidney who underwent PCNL from Jan-05 through Oct-13. Demographic data, stone characteristics, and intra- and postoperative outcomes were recorded. Spearman correlation was performed to assess which variables could impact on bleeding and surgical complications. Linear and logistic regressions were also performed.
  
  
  RESULTS
  Twenty-seven patients were enrolled in this study. The mean age and BMI were 45.6 years and 28.8Kg/m(2), respectively; 45% of cases were classified as Guys 3 (partial staghorn or multiple stones) or 4 (complete staghorn) - complex cases. Stone-free rate was 67%. Eight (29.6%) patients had postoperative complications (five of them were Clavien 2 and three were Clavien 3). On univariate analysis only number of tracts was associated with increased bleeding (p=0.033) and only operative time was associated with a higher complication rate (p=0.044). Linear regression confirmed number of access tracts as significantly related to bleeding (6.3, 95%CI 2.2-10.4; p=0.005), whereas logistic regression showed no correlation between variables in study and complications.
  
  
  CONCLUSIONS
  PCNL in solitary kidneys provides a good stone-free rate with a low rate of significant complications. Multiple access tracts are associated with increased bleeding.
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Fabio C M
authors.initials: FC
authors.lastname: Torricelli
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Guilherme P
authors.initials: GP
authors.lastname: Padovani
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Giovanni S
authors.initials: GS
authors.lastname: Marchini
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Fabio C
authors.initials: FC
authors.lastname: Vicentini
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Danilovic
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Reis
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.affiliation: Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mazzucchi
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D005260:Female; D006400:Hematocrit; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome