Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi

Vol. 42 (2): 262-269, March – April, 2016

doi: 10.1590/S1677-5538.IBJU.2014.0619


ORIGINAL ARTICLE


Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi

S V Krishna Reddy 1, Ahammad Basha Shaik 2

1 Department of Urology, Narayana Medical College, Nellore, Andhra Pradesh, India; 2 Department of Statistics, Sri Venkateswara University, Tirupati, Andhra Pradesh, India

ABSTRACT

Purpose: To compare the efficacy of percutaneous nephrolithotomy (PCNL) as a primary procedure of patients following previous open surgery or post percutaneous nephrolithotomy (PCNL) for renal calculi.
Materials and Methods: The medical records of 367 patients who underwent PCNL by a single surgeon from January 2008 to December 2013 were reviewed retrospectively. All patients were divided into 3 Groups. Group-1 (n=232) included patients with no history of ipsilateral open stone surgery. Group 2 (n=86) patients had undergone one or more open stone surgeries before PCNL, patients with failed or recurrence following PCNL were placed in Group-3 (n=49). The demographic data, operation duration, stone free rate (SFR), number of attempts to access the collecting system and intra operative and postoperative complications between the three Groups were compared.
Results: There was no difference in sex, Body Mass Index (BMI), stone burden and laterality among the three Groups. Operation time was significantly less in first Group, while there was a statistically significant difference in operation duration between second and third Groups (p<0.05). The number of attempts to enter the collecting system was lower in the first Group in comparison to other two Groups (p<0.5). There was no significant differences among three groups in stone free rate. Intra operative and postoperative complications were slightly more frequent in Groups 2 and 3. Mortality occurred in 1 patient with colon perforation in Group-2.
Conclusion: Our study demonstrated that PCNL can be performed in patients even as secondary procedure without further complications.

Keywords: Kidney Calculi; Nephrostomy, Percutaneous; complications [Subheading]

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