Effects of single versus multiple tracts on Percutaneous Nephrolithotomy outcomes

Abstract

Objectives: The study designed to compare outcomes and morbidities in patient undergoes multi tracts percutaneous nephrolithotomy (PCNL) versus single tract PCNL.
 Methods: From October 2019 to September 2020, 50 patients were prospectively investigated at Azadi Teaching Hospital and Vajeen Private Hospital in Duhok, Iraq. Group A included 25 patients who received single tract PCNL while group B had 25 patients who underwent multiple tract PCNL. Complex renal stones are treated with single or multiple tract PCNL depending on stone configurations and urinary system architecture utilising Guy's stone score. Laboratory and imaging data were correlated with stone size, stone-free rate, mean haemoglobin decrease, operation time, hospital stay, and postoperative problems.
 Results: 64% of cases are male and 36% are female. The mean stone size in Group A was 3.3 cm (ranges 2.0 - 4.9 cm), but in Group B it was 5.1 cm (ranges 3.3 - 7.4 cm), which is substantially bigger. Group A's mean operational time was 64.4 minutes (ranges from 30-115 minutes), which is statistically significant compared to multiple tracts' 80.2 minutes (ranges from 45-120minutes). The decline in mean hemoglobin between the two groups is statistically significant. Group A and B had 8% and 12% blood transfusions, which is not significant. Group A had a mean hospital stay of 28.2 hours (20-48 hours), whereas group B had 40.8 hours (ranges 24-96 hours). In group A, 16% of patients experienced post-operative fever, whereas in group B, 20% did. 84% of single tract PCNL and 88% of multiple tract PCNL were stone-free.
 Conclusion: Complex renal stones treated by multiple tracts PCNL; is efficient and safe with acceptable postoperative outcomes and complications in comparison to single tract PCNL.