Is percutaneous nephrolithotomy in thrombocytosis patient safe? A retrospective case series analysis

Percutaneous nephrolithotomy (PCNL) is the gold standard for large and complex renal stone despite other available modalities. PCNL techniques have been evolved with many modifications and innovation in the recent decade. It can be safely performed in elderly patient and children with highest stone-free rate (SFR) among all other modalities. However, as PCNL is a blind procedure, chance of bleeding is very high than other surgical modalities. If patient already had, hematological problem, then perioperative risk of bleeding increased significantly. We are presenting few cases of PCNL in thrombocytosis child and young adult. This is a retrospective analysis of four renal stone patients from 2017 to 2024. Surgical outcomes such as SFR and complications were analyzed and discussed. There were no major perioperative bleeding problems in our study. Mild-to-moderate thrombocytosis does not pose extra risk to bleeding. However, hematology opinion and informed decision are needed for risk stratification before performing PCNL.