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Is routine postoperative chest radiography needed after percutaneous nephrolithotomy?
Marc A Bjurlin1, Thomas O'Grady, Ronald Kim
1Division of Urology, Department of Surgery, Cook County Hospital, Cook County Health and Hospitals System, Chicago, Illinois 60612, USA.
Urology
|November 18, 2011
Summary
Routine postoperative chest X-rays (CXRs) are not necessary after percutaneous nephrolithotomy (PCNL). Selective CXRs are recommended only for symptomatic patients, improving cost-effectiveness and reducing radiation exposure.
Area of Science:
- Urology
- Radiology
- Nephrology
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- Routine postoperative chest radiography (CXR) is often performed to detect hydropneumothorax.
- The clinical impact of routine postoperative CXRs after PCNL is debated.
Purpose of the Study:
- To evaluate the necessity of routine postoperative chest radiography (CXR) after percutaneous nephrolithotomy (PCNL).
- To determine if routine postoperative CXRs influence the management of hydropneumothorax post-PCNL.
Main Methods:
- Retrospective review of 214 percutaneous nephrolithotomy (PCNL) procedures from 2007 to 2010.
- Analysis of patient demographics, operative details, postoperative chest radiography (CXR) findings, and complications.
- Inclusion of data on renal access, stone burden, and outcomes.
Main Results:
- Only 2 out of 214 patients (1%) developed hydropneumothorax, both with clinical symptoms.
- Postoperative CXR findings did not alter management for the identified cases.
- The mean hospital stay was 1.6 days, with a 0.5% mortality rate.
Conclusions:
- Routine postoperative chest radiography (CXR) is not indicated after percutaneous nephrolithotomy (PCNL).
- Selective CXR is a safe and cost-effective approach for patients with symptoms or suspected complications.
- This strategy reduces unnecessary radiation exposure and healthcare costs.
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