Postoperative Pulmonary Complications after Percutaneous Nephrolithotomy Under Spinal Anesthesia

Area of Science:

• Urology
• Anesthesiology
• Pulmonary Medicine

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
• Pulmonary complications (PCs) can occur after PCNL, impacting patient outcomes.
• Spinal anesthesia (SA) is an alternative anesthetic technique for PCNL.

Purpose of the Study:

• To identify risk factors for pulmonary complications (PCs) in patients undergoing percutaneous nephrolithotomy (PCNL).
• To evaluate the outcomes of PCNL-associated pulmonary complications (PCs) under spinal anesthesia (SA).

Main Methods:

• Retrospective analysis of 286 patients who underwent PCNL under SA (2017-2021).
• Patients were divided into groups based on the presence of clinically significant PCs.
• Demographic, preoperative, intraoperative, and postoperative data were compared; logistic regression identified risk factors.

Main Results:

• Pulmonary complications (PCs) occurred in 31.5% of patients.
• Advanced age, high body mass index (BMI), and chronic obstructive pulmonary disease (COPD) were significant risk factors for PCs.
• Spinal anesthesia (SA) was associated with a lower rate of PCNL-related PCs.

Conclusions:

• Spinal anesthesia (SA) is a safe and effective anesthetic choice for PCNL.
• Identifying and managing risk factors like advanced age, obesity, and COPD can help reduce PCs after PCNL.
• Further research may explore specific interventions to mitigate PC risk in high-risk PCNL patients.