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Outcome and clinical complications of percutaneous nephrolithotomy
4th EULIS Meeting Vienna, Austria
122
Outcome and clinical complications of percutaneous nephrolithotomy Eur Urol Suppl 2017; 16(7);e2599
Amador Robayna A. , Falcón Barroso J. , Fumero Arteaga S. , Carrión Valencia A. , Orribo Morales N. , Ballesta Martínez B. , Monllor Gisbert J. Nuestra Señora De Candelaria University Hospital, Dept. of Urology, Santa Cruz De Tenerife, Spain Introduction & Objectives: Percutaneous nephrolithotomy (PCNL) is considered the first-line treatment for large and complex renal stones, it is considered a minimally invasive technique by the hand of the improvements in the instruments and the minitualization of the same, anyway produces an aggression on the renal parenchyma. Analyze the clinical repercussion to percutaneous nephrolithotomy in our early learning curve. Evaluate the composition of renal lithiasis in our environment. Material & Methods: We conducted a prospective observational study since the beginning of percutaneous nephrolithotomy in our center from August 2014 to November 2016. We studied demographic variables, comorbidities and analytical data. We analyzed the data with non parametric tests using SPSS program 22. Results: In this period 20 PCNL were performed in our center, all in a supine position. The distribution by sex was 55% male (N = 11) and 45% female (N = 9) with a mean age of 50 years (SD 9.7). In the co-morbidities we observed a mean BMI of 29 (SD 4), an anesthetic risk (ASA) of 2 in 65% of the sample (range 1-3) and a mean Charlson comorbidity index of 2 (range 0-5 ). Fifty-five percent of patients received at least one ESWL session befote or after perform PNL. Analysis of renal function using the Wilcoxon test shows no variation in creatinemia after PCNL (p = 0.791). In the analysis of bleeding, the Friedman two-dimensional test was applied, which showed that the bleeding of the patients treated with PNL had repercussions on the blood count (p <0.05), however there was no hemodynamic impact of the same and only one patient (5%) required a blood transfusion. 95% (n = 19) of the patients left the operating room with the urinary diversion through nephrostomy and ureteral catheter and only one patient left without ureteral drainage. The composition of the stones was calcium oxalate in 55% (n = 11, 30% of mixtures with calcium phosphate), uric acid in 20% (n = 4), ammonium magnesium phosphate in 20% (n = 4) and 5% to calcium phospate (n = 1). Conclusions: In our short serie, we observed that PCNL does not affect the renal function of the patients , we confirm it is procedure with a statistically significant variation in the numbers of the red blood cell series, but only 5% of the cases have a hemodynamic repercussion.
Eur Urol Suppl 2017; 16(7);e2599
122
Outcome and clinical complications of percutaneous nephrolithotomy Eur Urol Suppl 2017; 16(7);e2599
Amador Robayna A. , Falcón Barroso J. , Fumero Arteaga S. , Carrión Valencia A. , Orribo Morales N. , Ballesta Martínez B. , Monllor Gisbert J. Nuestra Señora De Candelaria University Hospital, Dept. of Urology, Santa Cruz De Tenerife, Spain Introduction & Objectives: Percutaneous nephrolithotomy (PCNL) is considered the first-line treatment for large and complex renal stones, it is considered a minimally invasive technique by the hand of the improvements in the instruments and the minitualization of the same, anyway produces an aggression on the renal parenchyma. Analyze the clinical repercussion to percutaneous nephrolithotomy in our early learning curve. Evaluate the composition of renal lithiasis in our environment. Material & Methods: We conducted a prospective observational study since the beginning of percutaneous nephrolithotomy in our center from August 2014 to November 2016. We studied demographic variables, comorbidities and analytical data. We analyzed the data with non parametric tests using SPSS program 22. Results: In this period 20 PCNL were performed in our center, all in a supine position. The distribution by sex was 55% male (N = 11) and 45% female (N = 9) with a mean age of 50 years (SD 9.7). In the co-morbidities we observed a mean BMI of 29 (SD 4), an anesthetic risk (ASA) of 2 in 65% of the sample (range 1-3) and a mean Charlson comorbidity index of 2 (range 0-5 ). Fifty-five percent of patients received at least one ESWL session befote or after perform PNL. Analysis of renal function using the Wilcoxon test shows no variation in creatinemia after PCNL (p = 0.791). In the analysis of bleeding, the Friedman two-dimensional test was applied, which showed that the bleeding of the patients treated with PNL had repercussions on the blood count (p <0.05), however there was no hemodynamic impact of the same and only one patient (5%) required a blood transfusion. 95% (n = 19) of the patients left the operating room with the urinary diversion through nephrostomy and ureteral catheter and only one patient left without ureteral drainage. The composition of the stones was calcium oxalate in 55% (n = 11, 30% of mixtures with calcium phosphate), uric acid in 20% (n = 4), ammonium magnesium phosphate in 20% (n = 4) and 5% to calcium phospate (n = 1). Conclusions: In our short serie, we observed that PCNL does not affect the renal function of the patients , we confirm it is procedure with a statistically significant variation in the numbers of the red blood cell series, but only 5% of the cases have a hemodynamic repercussion.
Eur Urol Suppl 2017; 16(7);e2599