Feasibility and Efficacy of Percutaneous Nephrolithotomy, Initial Experience

Abstract

ABSTRACT:BACKGROUND:Renal stone disease is common in Iraqi population and percutaneous nephrolithoyomy present a minimal access for large stone a substitute for traditional open surgeryOBJECTIVE: We are presenting our first experience in percutaneous nephrolithotomy )PCNL( in terms of renal access, stone free and to evaluate the other aspects such as the need of auxiliary procedures in a center without prior experience in this field.MATERIALS AND METHODS:We evaluate all the PCNL performed in period of two year. A series of perioperative and post-operative details were recorded. All PCNL were performed in prone position. RESULTS: The first 55 PCNL cases were included in the study. Out of 55 patients, 16 were women and 39 men. Their mean age was 35.5 years (range 11-65) and means stone diameter were 23.5 mm ± 8.9. A successful renal access achieved in 87.3 % (48) cases with stone fragmentation. Procedures were performed over two year Dec.2013-Dec. 2015. Of fifty five patients 4 cases with single functioning kidney, and eleven cases with PCNL on same side of previous scar of pyelolithotomy. Stone free rate was 82%. Co morbidities included 8 hypertensive, 3 diabetics, one systemic lupus erythematosus and two with elevated blood urea.Morbidity and complications following PCNL are dominated by access failure in 12.7 % (n= 7); intraoperative bleeding in 3.6 % (n=2), urinary leakage in one patient, ureteric colic in 5.4 % (n=3) hydrothorax 1.8 % (n=1). None of these patients experienced post-operative bleeding, No mortalityCONCLUSION: PCNL can be learned by urologists who do not have the support of an experienced colleague without endangering patient safety.