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Percutaneous nephrolithotomy (PCNL) in patients with previous open stone surgery
Volkan Tugcu1, Fuat Ernis Su, Nadir Kalfazade
1Department of Urology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey. volkantugcu@yahoo.com
International Urology and Nephrology
|April 10, 2008
Summary
Previous open nephrolithotomy increases operative time for percutaneous nephrolithotomy (PCNL) but does not affect success rates or complications. This study compared PCNL outcomes in patients with and without prior open surgery.
Area of Science:
- Urology
- Nephrology
- Surgical Outcomes
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- Previous open nephrolithotomy may alter the surgical field for subsequent PCNL.
Purpose of the Study:
- To evaluate the impact of prior open nephrolithotomy on the technical aspects, outcomes, and morbidities of PCNL.
- To compare PCNL results between patients with and without a history of open nephrolithotomy.
Main Methods:
- A retrospective study comparing 160 patients undergoing PCNL.
- Group 1 (55 patients) had previous open nephrolithotomy on the same kidney; Group 2 (105 patients) had no prior open surgery.
- Key surgical features, operative time, success rates, and complications were analyzed.
Main Results:
- No significant differences in age, BMI, or stone burden between groups.
- Operative time was significantly longer in the prior open surgery group (155 min vs. 137 min).
- Secondary intervention rates (11% vs. 10%), sepsis, and blood transfusion requirements were similar between groups.
Conclusions:
- PCNL after open nephrolithotomy leads to increased operative time.
- Success rates and overall morbidities remain comparable between patients with and without prior open nephrolithotomy.
- Careful surgical planning is essential for PCNL in patients with a history of open renal surgery.
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