What is the difference between percutaneous nephrolithotomy in patients with and without previous open renal surgery?

In this study we aimed to determine the effects of previous open renal surgery on the results and complications of subsequent percutaneous nephrolithotomy (PCNL).

From October 2005 to October 2007, 104 patients underwent PCNL in our hospital. We compared the patients who undergone previous open surgery on the same kidney (group 1; n = 36) with those who had undergone no previous surgery (group 2; n = 68). We extracted requested information such as age, sex, stone number, stone burden, intraoperative and postoperative complications, hospital stay, access time, operative time, and success rate. The results of the study were analyzed using SPSS 10 software.

Intraoperative complications were seen in 11.11% of the group 1 patients and in 11.8% of the group 2 patients. Postoperative fever was seen in 33.3% of the patients in group 1 and in 26.5% of the patients in group 2. Mean hospital stay was 85.88 +/- 17.25 hours and 80.20 +/- 17.71 hours in group 1 and group 2, respectively. Mean operating time was 75.41 +/- 17.2 minutes in group 1 and 67.42 +/- 26.25 minutes in group 2. Stone-free rate was 88.9% in the group 1 patients and 79.4% in the group 2 patients. Step 1 access time in group 1 and group 2 was 120.02 +/- 68 seconds and 117.80 +/- 80.52 seconds, respectively (p = 0.002).

PCNL in patients who previously underwent open renal surgery is effective and safe. We found no difference in results between the two groups based on the number of stones and the number of accesses. The step 1 of dilatation was the only difference between the two groups.