Our percutaneous nephrolithotomy experiences: a single center experience with 533 patients

Aim: To evaluate efficacy and morbidity of the treatment in total 533 patients underwent percutaneous nephrolithotomy (PCNL).
Material and Methods: Between November 2004 and December 2011, the records of 533 patients with renal calculi who underwent PCNL were reviewed retrospectively. All patients were evaluated with intravenous urography and/or computerized tomography. Patient related factors such as age, body mass index (BMI), ipsilateral history of SWL, PCNL and open surgery together with stone size and localization and degree of hydronephrosis were noted. Number and localization of access, blood transfusion requirement, success rate, length of hospitalization, intraoperative and postoperative complications and secondary procedures were reviewed.
Results: The application of 533 PNL procedures, 226 women (%47.5), 280 men (%52.5), %47.5 right side, %52.5 left side, BMI 26.38 kg/m2, mean stone volume 4196.64 mm3 were determined. Before the PNL procedures, 134 patients were used ESWL(%25.1), open nephrolithotomy in 77 patients (%14.4), PNL 29 patients (%5.4) applied. 221 patients didn’t have hydronephrosis (%41.5), 312 patients had hydronephrosis (%58.5) was detected before the PNL procedures. 407 patients underwent singleport (%76.4), 2 ports with 86 patients (%16.1), 38 patients with 3 ports (%7.1), 1 patient was 4 port input. Balloon dilatator (%81.6), sequential dilatator (%17.8) were used. The mean of operation and fluoroscopy time 125.91 min and 6.1 min were detected. Perioperative complications occured in 39 patients (%7.1). Required blood transfusion in 81 patients (%15.2).
Conclusion: PNL method acceptable complication rate in the treatment of kidney Stones, can be administered safety and effectively.

Perkütan nefrolitotomi deneyimlerimiz: 533 vakalýk tek merkezdeki deneyimlerimiz

Amaç: Perkütan nefrolitotomi (PNL) yapýlan toplam 533 hastada tedavinin etkinliðini ve morbiditesini deðerlendirmektir.
Gereç ve Yöntemler: Kasým 2004-Ocak 2012 tarihleri arasýnda böbrek taþý nedeniyle PNL yapýlan 533 hastanýn kayýtlarý geriye dönük olarak incelendi. Hastalarýn tamamý intravenöz ürografi ve/veya abdominopelvik tomografiyle deðerlendirildi. Hastalar yaþ, cinsiyet, taraf, vücut kitle indeksi (VKÝ), ayný taraf açýk cerrahi, PNL, ESWL hikayesi gibi hastayla iliþkili faktörler ile birlikte taþ boyutu, taþýn lokalizasyonu, hidronefroz derecesi, akses lokalizasyonu ve sayýsý, operasyon ve floroskopi süreleri, intraoperatif ve postoperatif komplikasyonlar, kan transfüzyonu gereksinimi, baþarý oraný, hastanede kalýþ süreleri ve ikincil tedavi gereksinimleri açýsýndan deðerlendirildi.
Bulgular: 533 PNL uygulamasýnýn 226’sý bayan (%47.5), 280’i erkek (%52.5), %47.5’i sað taraf, %52.5’i sol taraf, VKÝ 26.38 kg/m2, ortalama taþ hacmi 4196,64 mm3 olarak tespit edildi. Operasyon öncesi 134 hastaya ESWL (%25.1), 77 hastaya açýk nefrolitotomi (%14.4), 29 hastaya PNL (%5.4) uygulanmýþ. Operasyon öncesi 221 hastada hiç hidronefroz olmadýðý (%41.5), 312 hastada (%58.5) hidronefroz olduðu tespit edildi. 407 hastaya tek port (%76.4), 86 hastaya 2 port (%16.1), 38 hastaya 3 port (%7.1), 1 hastaya 4 port giriþ yapýldý. 435 hastaya balon dilatatör (%81.6), 95 hastaya sýralý dilatatör (%17.8) kullanýldý. 494 hastada perioperatif komplikasyon görülmedi (%92.9). 39 hastada perioperatif komplikasyon görüldü (%7.1). 81 hastada kan transfüzyonuna ihtiyaç duyuldu (%15.2). Ortalama operasyon ve floroskopi süreleri 125.91 dk ve 6.1 dk tespit edildi.
Sonuç: PNL yöntemi böbrek taþlarýnýn tedavisinde kabul edilebilir komplikasyon oranlarýyla etkili ve güvenli bir þekilde uygulanabilir.