Complications attributable to the formation of the track in patients undergoing percutaneous nephrolithotomy
1Department of Diagnostic Radiology, Royal Surrey County Hospital, Guildford, Surrey.
Insights
Percutaneous nephrolithotomy complication rates can be low with experienced operators. Meticulous technique during this kidney stone procedure minimizes patient morbidity and operator radiation exposure.
Area of Science:
- Urology
- Interventional Radiology
Background:
- Complication rates for percutaneous nephrolithotomy (PCNL) show significant variability in reported literature.
- Optimizing procedural safety and minimizing radiation exposure are critical concerns in PCNL.
Purpose of the Study:
- To evaluate the complication rates of PCNL performed by an experienced interventional radiologist.
- To assess the radiation dose to the operator during PCNL.
- To determine the impact of specialized training on PCNL outcomes.
Main Methods:
- A retrospective review of 110 percutaneous nephrolithotomy procedures.
- Monitoring of radiation dose to the operator.
- Analysis of complication rates for the overall procedure and nephrostomy tract formation.
Main Results:
- The overall complication rate for PCNL was 3.6%.
- The complication rate for nephrostomy tract formation was 0.9%.
- Radiation dosages to the operator were maintained at very low levels through meticulous technique.
Conclusions:
- Experienced interventional radiologists can achieve favorable complication rates for PCNL.
- Adherence to meticulous technique is crucial for minimizing patient morbidity and operator radiation exposure.
- Prior interventional training significantly reduces complications and radiation dose in PCNL.
Abstract:
Reported complication rates of percutaneous nephrolithotomy vary considerably. In our own experience of 110 percutaneous nephrolithotomies performed by an experienced interventional radiologist, the complication rate for the entire procedure was 3.6%, and for the formation of the nephrostomy track 0.9%. This compares favourably with the reports from the major centres. Radiation dose to the operator was monitored and our results confirm that with meticulous attention to technique, dosages may be kept very low. We conclude that prior training in interventional techniques is a major factor in reducing both the morbidity associated with percutaneous nephrolithotomy and the radiation dose to the operator.
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