Related Experiment Videos
Percutaneous nephrolithotomy in patients with or without a history of open nephrolithotomy
Abbas Basiri1, Hossein Karrami, S Mohammadmehdi Hosseini Moghaddam
1Department of Urology, Labbafi Nejad Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. abbasbasiri@hotmail.com
Insights
A prior open nephrolithotomy does not negatively impact the success or complication rates of percutaneous nephrolithotomy (PCNL). This study found similar outcomes for patients undergoing PCNL with or without a history of open stone surgery.
Area of Science:
- Urology
- Surgical Innovation
- Nephrolithiasis Management
Background:
- The impact of prior open nephrolithotomy on subsequent percutaneous nephrolithotomy (PCNL) outcomes is not well-established.
- Understanding this relationship is crucial for surgical planning and patient counseling.
Purpose of the Study:
- To investigate whether a history of open nephrolithotomy influences the efficacy and morbidity of percutaneous nephrolithotomy (PCNL).
- To compare PCNL outcomes in patients with and without prior open stone surgery.
Main Methods:
- Retrospective comparison of 65 patients with prior open nephrolithotomy (Group A) versus 117 patients undergoing PCNL as their first surgery (Group B).
- All procedures performed by the same surgical team during the same time period.
- Analysis of stone characteristics, surgical success rates, and complication incidence.
Main Results:
- No significant difference in PCNL failure rates (6.15% vs 8.55%) or inaccessible collecting systems (6.2% vs 5.1%) between Group A and Group B.
- Similar rates of pyelonephritis and abnormal bleeding were observed in both groups.
- No other surgical complications were reported in either group.
Conclusions:
- A history of open nephrolithotomy does not adversely affect the efficacy of PCNL.
- Morbidity and complication rates are comparable between patients with and without prior open stone surgery when undergoing PCNL.
Background And Purpose:
Whether a history of open nephrolithotomy affects the efficacy and morbidity of percutaneous interventions remains unsettled. We investigated this issue in our patients.
Patients And Methods:
A series of 51 men and 14 women who had undergone nephrolithotomy at least once (group A; mean age 40 years) were compared with 73 men and 44 women submitting to percutaneous nephrolithotomy (PCNL) as their first surgery (group B; mean age 43 years). All patients were operated on by the same surgeons over the same period of time. Fifty patients (81.5%) in group A harbored a single stone, whereas 35.9% of patients in group B had single stones (P < 0.001). However, the two groups were similar in terms of stone laterality, the right:left ratio being 1.03 in group A and 0.67 in group B (P = 0.22).
Results:
The proportion of patients in whom PCNL failed to clear all the stones even though access was obtained did not differ in the two groups (6.15% in group A and 8.55% in group B; P = 0.77). The collecting system was inaccessible in 6.2% and 5.1% of patients, respectively (P = 0.74). Pyelonephritis or abnormal bleeding occurred in similar proportions in the two groups (P = 0.72 and P = 0.74, respectively). No other surgical complications occurred in either group.
Conclusion:
A history of open nephrolithotomy does not adversely affect the efficacy or morbidity of PCNL.