Abstract

Objective: Main treatment modalities for renal stones are extracorporeal shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), open surgery, or combination of PNL and SWL. In this retrospective study, we evaluated the success and complication rates of PNL in patients with renal calculi. 

Materials and methods: From November 2007 to December 2008, 76 renal stone patients (mean age 32.5; range 4-71 years) were treated with PNL. The mean stone burden was 5.54 (range 2-16) cm2. For 71 and 5 patients, subcostal and intercostal PNL accesses were performed, respectively. A nephrostomy tube was placed at the end of the procedure. Patients were evaluated with abdominal radiography on postoperative second day and with intravenous pyelography at postoperative  third month.

Results: Mean operation time was 105.94 (range 50-200) min and hospitalization duration was 2.97 (range 2-5) days. When the stones ≤4 mm were accepted in the successful group, total success rate was 75% (57/76). For 11 patients (14.4%), blood transfusion was performed for bleeding. Pelvic laceration, hydropneumothorax, and fever (>38°C) were seen in 3 (3.9%), 2 (2.6%), and 3 (3.9%) patients. Four patients (5.2%) underwent open surgical procedure due to the failure of PNL, while the operation was terminated in one (1.31%) due to the same reason. Fourteen patients with ≥4 mm residual fragments were considered for SWL.

Conclusion: After a certain number of patients with increasing experience, PNL can be considered as an effective and safe treatment option for renal stones with high success rates, short duration of hospitalization, and acceptable complication rates.