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Colonic perforation during percutaneous nephrolithotomy: An 18-year experience
Mohammad AslZare1, Mohammad Reza Darabi1, Behnam Shakiba1
1Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran.
Summary
Colonic perforation is a rare but serious complication of percutaneous nephrolithotomy (PCNL). Early diagnosis and conservative management, including percutaneous colostomy and antibiotics, led to complete healing in all patients.
Area of Science:
- Urology
- Surgical Complications
Background:
- Percutaneous nephrolithotomy (PCNL) is a primary treatment for large kidney stones.
- While generally safe, PCNL carries risks, including rare but severe colonic perforation.
- Colonic perforation can lead to life-threatening peritonitis and sepsis.
Purpose of the Study:
- To report on an 18-year experience with diagnosing and managing colonic perforation during PCNL.
- To evaluate the effectiveness of a conservative management strategy for this complication.
Main Methods:
- Retrospective review of 5260 PCNL procedures from May 1995 to August 2013.
- Analysis of preoperative and operative factors in patients who sustained colonic injury.
- Detailed review of management strategies and outcomes for colonic perforation.
Main Results:
- Colonic perforation occurred in 11 patients (0.21%).
- All injuries were retroperitoneal, affecting both left and right sides.
- Conservative management, including percutaneous colostomy, ureteral stenting, antibiotics, and nutritional support, resulted in complete healing in all cases.
Conclusions:
- Early identification of colonic perforation is crucial.
- Conservative management is effective in achieving excellent healing outcomes.
- This approach minimizes morbidity and mortality associated with PCNL-related colonic injury.
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