title: Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi.
abstract: OBJECTIVE
  To compare the efficacy of percutaneous nephrolithotomy (PCNL) as a primary procedure of patients following previous open surgery or post percutaneous nephrolithotomy (PCNL) for renal calculi.
  
  
  METHODS
  The medical records of 367 patients who underwent PCNL by a single surgeon from January 2008 to December 2013 were reviewed retrospectively. All patients were divided into 3 Groups. Group-1 (n=232) included patients with no history of ipsilateral open stone surgery. Group 2 (n=86) patients had undergone one or more open stone surgeries before PCNL, patients with failed or recurrence following PCNL were placed in Group-3 (n=49). The demographic data, operation duration, stone free rate (SFR), number of attempts to access the collecting system and intra operative and postoperative complications between the three Groups were compared.
  
  
  RESULTS
  There was no difference in sex, Body Mass Index (BMI), stone burden and laterality among the three Groups. Operation time was significantly less in first Group, while there was a statistically significant difference in operation duration between second and third Groups (p<0.05). The number of attempts to enter the collecting system was lower in the first Group in comparison to other two Groups (p<0.5). There was no significant differences among three groups in stone free rate. Intra operative and postoperative complications were slightly more frequent in Groups 2 and 3. Mortality occurred in 1 patient with colon perforation in Group-2.
  
  
  CONCLUSIONS
  Our study demonstrated that PCNL can be performed in patients even as secondary procedure without further complications.
authors.affiliation: Department of Urology, Narayana Medical College, Nellore, Andhra Pradesh, India.
authors.forename: S V Krishna
authors.initials: SV
authors.lastname: Reddy
authors.affiliation: Department of Statistics, Sri Venkateswara University, Tirupati, Andhra Pradesh, India.
authors.forename: Ahammad Basha
authors.initials: AB
authors.lastname: Shaik
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult