You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2016MP22-12 THE RELATIONSHIP BETWEEN OPERATIVE TIMES AND COMPLICATION RATES IN PERCUTANEOUS NEPHROSTOLITHOTOMY PROCEDURES Julie Stein, Kaitlan Cobb, John Michael DiBianco, and Patrick Mufarrij Julie SteinJulie Stein More articles by this author , Kaitlan CobbKaitlan Cobb More articles by this author , John Michael DiBiancoJohn Michael DiBianco More articles by this author , and Patrick MufarrijPatrick Mufarrij More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.700AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prolonged operative time has long been associated with postoperative complications. Percutaneous nephrostolithotomy (PCNL) is a common approach for the treatment of complex stone disease, often requiring lengthy operative times and/or multiple surgical stages. Complications of PCNL, including hemorrhage, injury to adjacent organs/structures, and infection, have been reported to occur at higher rates in procedures that have had prolonged operative times. Additionally, some of these complications may limit the duration of PCNL procedures, thereby decreasing stone-free rates or requiring more surgical stages. We aimed to investigate the relationship between operative times and postoperative complications as classified by the Clavien-Dindo System of Surgical Complications. METHODS A retrospective review was performed on 66 patients who underwent PCNL by a single endourologist at George Washington University Hospital and Sibley Memorial Hospital in Washington, D.C. from October 2012 to December 2014. Data on basic patient demographics and characteristics, operative times, and complications were collected. Operative time was defined by surgery start time and stop time as recorded by the anesthesiologist. Complications were classified by the Clavien-Dindo system on a scale of 0 to 5. RESULTS Mean age of patients was 57.3 +/- 12.2 years. Overall complication rate was 14.9% with 0% Clavien I, 9.0% Clavien II, 0% Clavien III, 6.0% Clavien IV, and 0% Clavien V. Mean operative time was 232.0 +/- 72.7 minutes. A simple linear regression model revealed that operative time accounted for 6.1% of the variance in Clavien score (R2 = .061, p < 0.05). One-way Analysis of Variance (ANOVA) demonstrated that the presence of infection stones differed significantly between Clavien classes (F(2, 60) = 3.32, p = 0.043). Post-hoc analyses showed that infection stones were associated with a Clavien II complication (p = 0.05), but not with a Clavien IV complication (p > 0.05). CONCLUSIONS In our investigation, increased operative time of PCNL procedures was not associated with an increase in complications. The increase in mid-level complications observed in patients identified to have infection-based stones corroborates previous data on this particular group of stone patients. While, in general, it is advisable to minimize operative duration, this data does not suggest an increased complication risk with lengthier PCNL procedures. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e257-e258 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Julie Stein More articles by this author Kaitlan Cobb More articles by this author John Michael DiBianco More articles by this author Patrick Mufarrij More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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