Percutaneous Nephrolithotomy and Complications: Our Experience with 3,003 Cases

Abstract

We report the outcomes of 3,003 percutaneous nephrolithotomy (PCNL) procedures performed in our institution between March 1998 and December 2014. The PCNL procedures were performed under general anaesthesia. The ureteral catheter was installed in the supine position during cystoscopy under C-arm fluoroscopy guidance and, after turning the patient into the prone position, the kidney with stone was entered with a metal needle under fluoroscopy. The Amplatz renal dilator set was used (dilation or balloon renal dilator). The nephrostomy catheter was placed in the renal sheath. After completion of PCNL procedures, residual asymptomatic stones of 4 mm or less in size were considered clinically insignificant. Of the total number of patients, 2,699 (89.88%) achieved stone clearance. Bleeding requiring transfusion occurred in 186 cases (6.19%), of which 14 (0.47%) were treated with embolisation angiography. A double-J stent was inserted in 158 patients (5.26%). Pneumothorax occurred in 24 patients (0.80%) and colon perforation occurred in one patient (0.03%). In angiography, the bleeding site was not identified in one patient and open repair was performed. Mean duration of hospitalisation was 3.3 days and the nephrostomy tube was kept for a mean duration of 2.6 days.