ABSTRACT

To investigate whether percutaneous nephrolithotomy (PNL) can be performed safely and effectively in patients who have previously undergone open nephrolithotomy.

A total of 533 PNL procedures were divided into two groups; PCNL’s with (Group-1, n=456) and without previous open nephrolithotomy (Group-2, n=77). Both groups were compared for age, body mass index (BMI), stone burden, presence of hydronephrosis, localization of stone, operation and fluoroscopy times, number of accesses, complication rate, rate of stone-free status, need for blood transfusion, nephrostomy catheter removal time, and hospital stay. The qui-square, Mann-Whitney U, and Kruskall Wallis tests were used for statistical analyses. A p value of <0.05 was considered as significant.

No statistically significant difference was seen between the groups regarding gender, BMI, age, stone volume, presence of hydronephrosis, localization of stone, rate of stone-free status, need for blood transfusion, operation and fluoroscopy times, complication rates, time to remove nephrostomy catheter, and hospital stay (p>0.05). The number of ports was significantly higher in Group 2 than the group-1 (p=0.01). The presence of hydronephrosis in Group 1 (63.5%) was higher than Group 2 (p=0.022). A history of prior ESWL was found to be higher in Group 1 (35.1%) compared to Group 2 (p=0.03).

PNL may be performed effectively and safely in kidney stone patients who have previously undergone open nephrolithotomy. Due to the changes in anatomy, the number of accesses might increase and additional interventions might be required in previously operated patients. (JAREM 2012; 2: 113-6)

Keywords: PCNL, kidney stone disease, open surgery, complications