Abstract
To identify the perioperative factors associated with complications after percutaneous nephrolithotomy by classification of complications according to the modified Clavien scoring system and evaluation of the minor and major complications related to the procedure. A prospective study of all the percutaneous nephrolithotomy performed by standard technique within 1.5 years at Bir Hospital was made. Possible demographic, preoperative and intraoperative variables were included in the study and patients were followed up postoperatively for any complications. All complications were classified according to modified Clavien scoring system and analyzed to identify the prognostic variables. Two hundred and forty six percutaneous nephrolithotomy done within the study period were analyzed. Although 41.06 % of the study population developed complications, only 9.35 % had major complications. Age, body mass index, gender, clinical presentation, history of previous surgery and ASA score did not correlate with complications. Diabetes was the only comorbidity associated (p = 0.0482). Preoperatively estimated stone burden (p = 0.0023), number of calyces involved by the stones (p = 0.0002), and presence of staghorn calculi were significantly associated with development of postoperative complications. Multiple tracts were required (p = 0.0151) and operative time was longer (p < 0001) in the patients who developed complications. Percutaneous nephrolithotomy has lesser complications. Diabetic patients are more prone to develop complications. Larger stone burden, involvement of multiple calyces by stones and staghorn calculi are associated with need of multiple tracts and longer operative time, thus predisposing to higher incidence of complications.
Highlights
MethodsA prospective study of all the percutaneous nephrolithotomy performed by standard technique within 1.5 years at Bir Hospital was made
To identify the perioperative factors associated with complications after percutaneous nephrolithotomy by classification of complications according to the modified Clavien scoring system and evaluation of the minor and major complications related to the procedure
We present the results of percutaneous nephrolithotomy (PCNL) with the aim to determine the preoperative and perioperative prognostic factors of complications associated with PCNL
Summary
A prospective study of all the percutaneous nephrolithotomy performed by standard technique within 1.5 years at Bir Hospital was made. Preoperative and intraoperative variables were included in the study and patients were followed up postoperatively for any complications.All complications were classified according to modified Clavien scoring system and analyzed to identify the prognostic variables. After ethical clearance for the study from the subject committee of department of urology and institutional review board, a prospective observational study of all patients who underwent PCNL at Bir hospital of Kathmandu, Nepal, was undertaken from August 2015 to January 2017. All PCNL done in prone position, transpapillary puncture made with help of fluoroscopic guidance using 18 gauze two-part needle after retrograde opacifiation of the pelvicaliceal system via the ureteral catheter were only included in the study. Intraoperative variables studied included operative time and number and location of the tracts
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