Study of Percutaneous Nephrolithotomy, Outcome and Analysis

Abstract

Background- Percutaneous nephrolithotomy is the mainstay for treating staghorn calculi. History of ipsilateral renal stone surgery and stone burden are prognostic factors determining stone clearance after PCNL on staghorn stones.

Methods and materials- In the present series, 60 patients were included in the study. Procedure was done by single surgeon. The patients with simple renal calculi were preferred. In all cases spinal anesthesia was used. The site of puncture it was subcostal. No procedure was converted in to the open nephrolithotomy. Cooks’ nephrostomy set and Metallic renal dilator sets were found to be safe, easy to use and reusable. The irritant fluid used was isotonic saline which was cheap, easily available and safe. All cases were done as single staged procedures and found to be safe.

 Results- During the course of study, we failed to extract all calculi in 9 cases. Hence, they will require second sitting PCNL for complete stone clearance. The average number of days of stay in the hospital were 4 days and average days for full recovery after surgery was nearly 5 days.

Conclusion- PCNL is a safe and reliable procedure for treating kidney stones if done by an expert hand with adequate instrumentation. It can achieve a stone clearance of almost 85% and with acceptable morbidity. However, this study is limited as the number of patients is small and it is done by a single surgeon without any randomization. But as this procedure was recently started in our department there was a need to evaluate this procedure in our setup.