title: Can percutaneous nephrolithotomy be performed as an outpatient procedure?
abstract: OBJECTIVE
  To examine the safety and effectiveness of percutaneous nephrolithotomy (PCNL) as an outpatient procedure, as in most centres PCNL is performed as an inpatient procedure that necessitates postoperative hospital admission.
  
  
  METHODS
  Our study included 186 patients undergoing PCNL for renal calculi. Only those who met strict inclusion criteria were discharged home on the same day. Preoperative eligibility criteria for outpatient management included no complex medical problem, normal renal function, and easy access to an emergency room. Patients were divided into two groups. The outpatient group (Group 1) included those patients discharged on the same day as the PCNL and the hospitalised group (Group 2) included those who were considered appropriate for outpatient management but needed to be hospitalised.
  
  
  RESULTS
  In all, 162 patients (87%) fulfilled the inclusion criteria for outpatient management and 146 of these patients (90.1%) planned for outpatient management were discharged on the same operative day (Group 1). The mean time to discharge home was 8.97 h. In all, 16 patients who opted for the outpatient approach subsequently required hospitalisation (Group 2). In the hospitalised group the mean operative time was longer, which was probably related to its higher stone burden.
  
  
  CONCLUSIONS
  PCNL can be safely performed with excellent outcomes as an outpatient procedure. Outpatient PCNL offers several advantages including a more rapid patient convalescence, reduced healthcare expenditure, decreased postoperative nosocomial infections with no additional morbidity for the patient, and with no compromising of the stone-free rate.
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fahmy
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Rhashad
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Omer
authors.initials: O
authors.lastname: Algebaly
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: Sameh
keywords: ER, emergency room; Outpatient procedure; PCNL, percutaneous nephrolithotomy; Percutaneous nephrolithotomy; SFR, stone-free rate; Standard of care