Outcome of PCNL- Success &Complications

Abstract

Percutaneous nephrolithotomy (PCNL) is now considered as the standard treatment for large and complex renal stones. The outcomes of PCNL can be interpreted in terms of success and complication rates. Recent attempts to report complication rates of PCNL have focused on stratifying them by severity by use of the Clavien Dindo grading system. The Guy's Stone Score (GSS) used to classify the burden of stones. This was a prospective study conducted by the department of Urology, NIMS hospital, Jaipur. In study of 508 PCNL cases, overall stone free status achieved in 88.72% of cases. Stone free status for GSS 1- 100%, GSS 2- 93.95%, GSS 3- 79.5%, GSS 4-39. In GSS 4 all cases were of staghorn calculus. Post- operative complications classified by the modified Clavien Dindo grading system. Fever was most common complication encountered (32.39%). Other frequent complications were haematuria requiring blood transfusion (24.88%), perinephrostomy urine leak (17.37%) and UTI requiring change of antibiotics (11.26%). Pneumothorax, post-operative JJ stent placement and clot retension requiring bladder wash were rare. Grade 4 and 5 complications were not encountered in our study.