Is an overnight stay after percutaneous nephrolithotomy safe?

Area of Science:

• Urology
• Nephrology
• Surgical Outcomes

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large kidney stones.
• Typical hospital length of stay (LOS) after PCNL is 2-5 days.
• Optimizing hospital resource utilization is crucial in managing patient flow.

Purpose of the Study:

• To establish and evaluate a clinical pathway for same-day or next-day discharge after PCNL.
• To assess the safety, effectiveness, and feasibility of early discharge.
• To identify factors influencing postoperative length of stay (LOS) exceeding one day.

Main Methods:

• Retrospective chart review of 109 patients undergoing PCNL.
• Analysis of demographics, LOS, complications (modified Clavien classification), stone-free rates, and readmissions.
• Bivariate analyses to determine associations between LOS and patient/surgical variables.

Main Results:

• Mean LOS was 1.7 days, with 20% of patients staying longer than one day.
• Stone-free rate was 89%.
• No significant difference in readmissions or need for further procedures between early and later discharge groups. No factors were associated with prolonged LOS.

Conclusions:

• An overnight hospital stay following PCNL is safe and feasible for selected patients.
• This pathway enhances hospital bed efficiency.
• Patient age, BMI, stone size, and operative time did not correlate with longer LOS.