Percutaneous Nephrolithotomy 500 Cases in High-Risk and Altered Renal Function Test: Our Experience at Tertiary Care Centre

Abstract

Introduction
The study aims to evaluate the results of percutaneous nephrolithotomy (PCNL) in high-risk patients and patients with altered
renal function tests (RFT) and complications in the management of renal stones in our hospital.
Methods
We retrospectively analyzed the outcomes of 500 patients who underwent PCNL between September 2020 and September 2023.
We have analyzed data regarding patient details, investigations, PCNL puncture site, operative duration, number of punctures,
stone-free rates (SFRs), duration of hospital stay, and complications.
Results
Out of 500 patients, 384 (76.87%) were males and 116 (23.13%) were females, with a male-to-female ratio of 3.32:1. The average
age was 40.8±10.4 (mean±SD) (range: 24 to 74-years). The average operative time was 127±37 min (mean±standard deviation
(SD)). The radiation exposure was from 1 min 30 sec to 3 min, with a mean (±SD) of 30 sec. The mean duration of the hospital
stay was 2.7±1.6 days. Complete stone clearance was 87%, whereas SFRs defined by no identifiable stone on a plain radiograph or
ultrasound or residual fragments <5 mm were 90.93%. The complication rate was 2.2%.
Conclusion
The usual course of treatment for renal stones larger than 2 cm is PCNL. Significant factors influencing the stone-free rate include
stone burden, stone type, PCNL puncture, number of punctures, and operative time. With the development of several lithotripsy
procedures and the miniaturization of instruments, PCNL continues to be an excellent therapeutic option for patients with large
renal stones, comorbidities, and changed RFT, with tolerable rates of complications.