Percutaneous Nephrolithotomy (PCNL) in Adult Patients: Our Initial Experience at Teaching Hospital Dera Ghazi Khan

Abstract

Objective: To evaluate our initial experience of PCNL for the management of renal stones in terms of stone clearance and complications.

Study Design: Prospective Observational Study

Place and Duration of Study: This study was conducted at the Urology department of Tertiary Care Teaching Hospital Dear Ghazi Khan between July 2018 to July 2020.

Materials and Methods: We included  72  adults patients with renal stones 15-50 mm. PCNL was  performed in prone position under general anesthesia. Patients with anomalous kidney, stage horn stones, and simultaneous PUJ narrowing, bleeding diathesis cardiopulmonary diseases, obese and pediatric age were excluded.

Results: The mean age of patients was 33 years with 12±sd and mean stone size was 24mm with 8.4± sd. Mostly were male 68% (n=49).Highest percentage of stones found in renal Pelvis (71%).Single stone was in 71% patients. Upper pole was the most common site of puncture (73.6%), while single puncture was done in 80% patients. Regarding the stone clearance 90.3% have complete  stone clearance while 6 patients (8.3%) has residual stones ranging  from 6mm- 15 mm. Procedure  was abandoned in one patient due to failure tract access. Patients with residual stones (n=6) 8.3% underwent ancillary procedure later on. Three patients (4.2%) developed urinoma managed by URS and DJ stent insertion. One patient got urosepsis and one developed paralytic ileus. Only 2(2.8%) patients needed blood transfusion.

Conclusion: PCNL was new treatment modality at our set up yet this technique encourages us to say good bye to open surgery in future. PCNL being standard and safe procedure, is to be adapted at least at every district level hospital