PERCUTANEOUS NEPHROLITHOTOMY FOR THE TREATMENT OF RENAL STONES LARGER THAN 2.5 CM

Abstract

Objectives: To share our experience regarding the safety and efficacy of Percutaneous Nephrolithotomy

for the treatment of renal stones of larger than 2.5 cm and to study the frequency of any postoperative

complications associated with this procedure.

Methodology: This is a descriptive study conducted during the period from June 2007 to December 2009.

Using non-probability convenient sampling, total 88 patients with renal stones of more than 2.5 cm were

selected for PCNL. Data was analyzed on SPSS version 10 for windows XP.

Results: In a cohort of 88 patients (57 male and, 31 female) PCNL was performed for renal stone

treatment. The mean age was 33.5 (9 – 65) years. The mean operative time was 85 (60 – 180) minutes and

the mean stone size was 3.2 cm range (2.5-4.8) cm. There were 37 staghorn and 51 non staghorn stone.

PCNL via a single access tract was accomplished in 86% (76/88) of procedures, with upper pole calyx in

30, middle calyx in 27 and lower pole calyx in 19 procedures, while multiple tracts were used in 14% of

procedures (12/88) with 09 procedures using the upper and middle calyxes and 05 procedures using lower

and middle calyxes. The stone-free rates for staghorn stone at discharge and at 3 months were 83.7% and

90.8% respectively, while for non staghorn stone the figures were 85.8% and 92.5% respectively.

Postoperative complications were observed in 9% of the procedures (8/88), the commonest of which was

bleeding necessitating blood transfusion in 4 patients.

Conclusion: PCNL is safe and Effective treatment for renal calculi associated with less morbidity, shorter

hospital stay and is cost effective.