Postoperative Pulmonary Complications among Patients Undergone Percutaneous Nephrolithotomy

Abstract

Background: Post-operative pulmonary complications (PPC) are not unusual following anesthesia and surgery in PCNL as the incidence is being higher. Complication rates vary according to different procedures and different types of anesthesia and may be affected by the patient condition. Objective: To assess postoperative pulmonary complications among the patients who had undergone PCNL. Methodology: This was a prospective observational study of 111 consecutive adult patients over a period of one year who underwent PCNL surgery. The data of the patient, surgery and anesthesia was collected and analyzed to find association with PPC. Results: Seven patients (6.3%) had developed pulmonary complications postoperatively, six of them had pneumothorax and one had atelectasis who, died at the 15 th postoperative day due to respiratory failure. All the 6 patients with pneumothorax were managed by inserting a chest drain. The other non pulmonary complications among the patients were shivering (40%), blood loss (15%), hyperthermia (9%). It is seen that patients who had a history of smoking and the patients who were operated on the left kidney had shown more incidence of developing pneumothorax and the difference was found to be statistically significant (p<.05). Conclusions: From the present study it can be concluded that the most common type of post-operative complication following PCNL is pulmonary, with pneumothorax. A close working relationship between the surgeon and anesthetist is essential to coordinate the access puncture with deflation of lung and ventilator standstill to minimize the chances of pleural injury.