UroToday.com- This single center retrospective study reviewed 1338 patients undergoing percutaneous nephrolithotripsy for management of staghorn calculi. The primary purpose of this report was to present stone-free rates and complications. Almost 50% of these patients had significant medical co-morbidities with the most common ones being hypertension, cardiac disease, diabetes, and neurologic disease. The mean stone burden was 941 mm2, the stone size ranged from 1 to 500 mm2 in 53% of the patients and 501 to 1000 mm2 in 27% of the patients. The majority of cases (91%) were performed through a single percutaneous access tract through a lower pole calix (66.4%). The mean length of hospital stay was four days and 25% of the patients required a secondary procedure. The overall stone-free rate was 94.8%. The overall complication rate was 11.5% with 6% minor bleeding and 0.8% bleeding requiring blood transfusion or embolization. Two patients in this group died in the perioperative period (0.13%); one was from a pulmonary embolism in an elderly patient with significant medical co-morbidities and the other patient suffered a colonic perforation due to a perforated diverticulitis. This article provides an excellent contemporary update of complications related to percutaneous nephrolithotripsy. It is apparent that this is a highly effective procedure and may be performed in a diverse group of patients with relatively low overall morbidity and mortality rates.
Duvdevani M, Razvi H, Sofer M, Beiko DT, Nott L, Chew BH, Denstedt JD
J Endourol. 21(8):824-829, August 2007
DOI: 10.1089/end.2007.9936
Reported by UroToday.com Contributing Editor Elspeth M. McDougall, M.D
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