Contemporary practice of percutaneous nephrolithotomy: review of practice in a single region of the UK.

Annals of the Royal College of Surgeons of England
Shalom J SrirangamDonald Neilson

Abstract

Most series of percutaneous nephrolithotomy (PCNL) from single specialised centres represent optimum results achievable and may not reflect outcomes of everyday practice. We analysed the practice in our region. Medical records of 178 patients undergoing PCNL in 2002 in 12 participating hospital trusts were retrospectively analysed. Even outside the tertiary referral centres, there was a 6-fold difference between trusts in the frequency of PCNL. In 28% of cases, another stone-removing modality had been tried first. Failed renal puncture was a major cause of abandoning surgery (9%). An indication of the difficulty in obtaining complete stone clearance is that only 107 (60%) operation notes recorded complete clearance, while 75 (42%) patients required a subsequent procedure (13% a secondary PCNL). Use of supra 12th rib punctures was small (6%) as was the rate of 'tube-less' PCNL (4%). Some 22% had simultaneous ureteric stent insertion. Approximately 8% of cases required a blood transfusion. Thirty-eight patients (23%) had a proven infection (UTI) pre-operatively (> 10(4) organisms; > 10 white blood cells) with almost all patients receiving antibiotics at anaesthesia induction. Postoperative sepsis rates (temperature > 38.5 degrees...Continue Reading

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Citations

Dec 3, 2008·Journal of Endourology·Seyed Mohammad Kazem AghamirMehrdad Sheikhvatan
Feb 15, 2011·Cardiovascular and Interventional Radiology·Alex M BarnacleDerek J Roebuck
Aug 25, 2012·Cardiovascular and Interventional Radiology·Tze M WahAzad Najmaldin
Sep 11, 2012·BJU International·Stephen R KeoghaneByron H Walmsley
Aug 28, 2012·Urologia Internationalis·Serdar ToksozHakan Ozkardes

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