Feasibility and Efficacy of Percutaneous Nephrolithotomy, Initial Experience
Iraqi Postgraduate Medical Journal,
2016, Volume 15, Issue 3, Pages 334-337
Renal stone disease is common in Iraqi population and percutaneous nephrolithoyomy present a minimal access for large stone a substitute for traditional open surgery
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.
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 mortality
PCNL can be learned by urologists who do not have the support of an experienced colleague without endangering patient safety.
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