Title: A Prospective Study of Success Rate of Percutaneous Nephrolithotomy for the Management of Renal Pelvic Calculi

Authors: Dr Ankita Yadav, Dr Ankit Sahu

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.93

Abstract

Background: Renal stones are one of the common problems affecting large number of population all over the world. Percutaneous Nephrolithotomy (PCNL) is a promising technique for reducing hospital stay in patients with renal stone surgery.

Aims and Objective: To study the stone size and success rate of PCNL in patients with renal calculi.

Materials and Methods: Ninety renal calculi patients were studied at SVBP Hospital attached to LLRM Medical College Meerut from June 2016 to Sept 2017. After a thorough history taking, detail of demographic and clinical findings including age, sex, stone size, hospital stay and success rate were recorded for each patient. All the statistical analysis was done using IBM SPSS ver.20 software.

Results: Maximum patients belong to age group of 21-60 years with mean age of 36.24±13.81 years. Male preponderance was reported (70%). Majority of the patients had right sided stone (60%), single (72%) and upper calyx was the most common PCN puncture site (54.44%). Maximum (91%) underwent drainage by DJ stent, had duration of hospital stay of 4-6 days (62.2%). Most of the patients had operative time within 60 mins (54.4%). Maximum patients (90%) achieved total clearance.

Conclusion: PCNL should be the first-line treatment modality for the management of the renal calculi. In addition to advantage of minimally invasive therapy, it also offers shorter hospital stay and higher stone-free rates.

Keywords: Upper calyx, renal stone, percutaneous nephrolithotomy.

References

  1. Koga S, Arakaki Y, Matsuoka M, Ohyama C. Staghorn calculi – long-term results of management. Br J Urol 1991 Aug; 68(2):122-124.
  2. Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr; AUA Nephrolithiasis Guideline Panel. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 2005 Jun;173(6):1991-2000.
  3. Wickham JE, Kellett MJ. Percutaneous nephrolithotomy. Br J Urol 1981 Aug; 53(4):297-299.
  4. Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G, Smith AD. “Angular percutaneous renal access.” Multiple tracts through a single incision for staghorncal-culous treat- ment in a single session. EurUrol 2005 Nov;48(5):832-837.
  5. de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A; CROES PCNL study group. The clinical research office of the endourological society percutaneous nephrolithotomy global study: indications, complications, and outcomes in 5803 patients. J Endourol 2011 Jan;25(1):11-17.
  6. Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007 Apr;69(4):603-607.
  7. Khan S, Toori LA, Anwer K. The efficacy of percutaneous nephrolithotomy in renal and upper ureteric calculi. Pakistan J Med Res 2005;44(2):89-91
  8. Srivastava A, Singh KJ, Suri A, Dubey D, Kumar A, KapoorR, et al. Vascular complications after percutaneous nephrolithotomy: are there any predictive factors? Urology.2005;66:38-40
  9. Reddy SVK, Shaik AB. Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi. Vol. 42 (2): 262-269, March - April, 2016
  10. Raut N, Singhania P, Joshi N, Shringarpure S, Sathe S, Tiwari N. Prospective Study of Percutaneous Nephrolithotomy in the Management of Renal Calculi. MGM Journal of Medical Sciences, January-March 2017;4(1):1-5
  11. Khawaja AR, Dar TI, Sharma AK, Bashir F, Tyagi VK, Bazaz MS. Post percutaneous nephrolithotomy nephrosto- gram: is it mandatory? A single center experience. AdvUrol 2014;2014:423730.
  12. Lingeman JE, Coury TA, Newman DM, et al. Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. J Urol 1987;138(3):485–90.
  13. Segura JW, Preminger GM, Assimos DG, et al. Nephrolithiasis clinical guidelines panel summaryreport on the management of staghorn calculi. The American urological association nephrolithiasis clinical guidelines panel. J Urol 1994;151 (6): 1648–51.
  14. Streem SB, Yost A, Dolmatch B. Combination ‘‘sandwich’’ therapy for extensive renal calculi in 100consecutive patients: immediate, long-term and stratified results from a 10-year experience. J Urol1997;158(2):342–5.
  15. Denstedt JD, Razvi HA, Dushinski J, et al. Percutaneous treatment of large and staghorn renalcalculi. J Endourol 1996;10 (Supp 1):S140, P11–328 (Abstract).
  16. Hayder MA. Percutaneous nephrolitho-tomy for renal calculi: a single surgeon experience. Iraqi Postgraduate Med J 2013; 12(4):573-80.
  17. Hegarty NJ, Desai MM. Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. J Endourol 2006 Oct;20 (10):753-60.

Corresponding Author

Dr Ankit Sahu

Department of General Surgery, Sharda University, Greater Noida, UP, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: 8745013181