Peri-operative predictors of postoperative bleeding and sepsis after percutaneous nephrolithotomy

Abstract

Introduction: Percutaneous nephrolithotomy (PCNL) is the most common minimal access method used for the management of large renal and pelvic stones. The two most common complications after PCNL are bleeding and sepsis. In this context, we did this study to find out perioperative predictors of postoperative bleeding and sepsis after PCNL. Materials and Methods: We conducted this study on 110 patients who came for PCNL at our institute from March 1, 2018 to August 31, 2019. Data were collected using a pro forma, and the same analyzed by appropriate statistical methods using the SPSS software. Results: The perioperative factors correlated to postoperative bleeding were stone size, density of stone, Guy's stone score, size of Amplatz sheath used, number of working tracts created, and duration of surgery. On regression analysis factors which were predictive of postoperative bleeding were size of Amplatz sheath and number of working tracts created. Peri-operative factors correlated with postoperative sepsis were body mass index of the patient, preoperative total count, density of stone, preoperative pyuria, preoperative positive urine culture, superior calyceal puncture, postoperative total leukocyte count, and postoperative fever within 24 h. The factors which were predictive of postoperative sepsis were preoperative pyuria, preoperative urine culture, superior calyceal puncture, and postoperative fever on regression analysis. Conclusion: This study shows perioperative predictors of postoperative bleeding and sepsis after PCNL. Out of 43.63% total complications, 20% were major and 23.63% minor complications.