Ambulatory mini percutaneous nephrolithotomy (mini-pcnl): feasibility and outcomes in 1000 cases in Pakistan | [Pakistan Armed Forces Medical Journal • 2020]

Author(s):

1. Qamar Zia: Combined Military Hospital Lahore/National University of Medical Sciences (NUMS),Pakistan

2. Faran Kiani: Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

3. Mudassar Sajjad: Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan

4. Muhammad Nawaz: Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

5. Muhammad Akmal: Combined Military Hospital Lahore/National University of Medical Sciences (NUMS),Pakistan

6. Adil Khurshid: Combined Military Hospital Lahore/National University of Medical Sciences (NUMS),Pakistan

7. Asma Rizwan: Combined Military Hospital Lahore/National University of Medical Sciences (NUMS),Pakistan

8. Muzzammil Ali: Combined Military Hospital Lahore/National University of Medical Sciences (NUMS),Pakistan

Abstract:

Objective: To review the outcomes of a consecutive cohort of 1000 patients with renal stones managed with minipercutaneous nephrolithotomy at our institute. Study Design: Prospective observational study. Place and Duration of Study: Armed Forces Institute of Urology Rawalpindi, Pakistan, from Jan 2016 to Dec 2018. Methodology: Surgery was carried out under general anesthesia in prone position. Access was made by single step dilatation by 14-17 French sheath, pneumatic lithoclast was used for stone disintegration and fragments removed. Foley and ureteric catheters were removed following morning of surgery after confirming stone clearance on plain X-Ray kidney ureter and bladder. Results: Mean stone size was 3.1 ± 2.1cm (2-6). Upper pole access was utilized in 398 (39.8%) while lower pole in 587 (58.7%) cases. Mean operative time was 67 ± 15.4 minutes (45-120) while the mean hospital stay was 22 ± 13.2 hours (20-120). A complete clearance rate of 93.3% was achieved as assessed by plain X-Ray kidney ureter & bladder. Residual stones were treated with either shock wave lithotripsy or redo mini-Percutaneous Nephrolithotomy. 910 (91%) of patients were discharged within 24 hours of surgery. Conclusion: Mini Percutaneous nephrolithotomy was found as a safe and feasible alternative contemporary established technique for treatment of nephrolithiasis which can be offered as a day case surgery except for complete staghorn calculi.

Page(s): 469-473

DOI: DOI not available

Published: Journal: Pakistan Armed Forces Medical Journal, Volume: 70, Issue: 2, Year: 2020

Keywords:

Percutaneous nephrolithotomy , Ambulatory care facility , Hematuria , Kidney stones , Renal calculi , Therapeutic chemoembolization , Thoracotomy

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