Risk Factors for Postoperative Complications after Percutaneous Nephrolithotomy

Basnet, Robin Bahadur; Shrestha, Anil; Shrestha, Pratik; Joshi, Bishwa Raj

doi:10.3126/jnhrc.v16i1.19371

Cited by 11 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Percutaneous nephrolithotomy is a minimally invasive and reproducible method for the treatment of kidney stones, and the procedure is repeatable. Although percutaneous nephrolithotomy has become the standard treatment for kidney stones, there is still a potential risk of complication [6–8].…”

Section: Discussionmentioning

confidence: 99%

The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

Meng

Bao

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Objective. This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods. The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results. A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions. Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.

show abstract

Section: Discussionmentioning

confidence: 99%

The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

Meng

Bao

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…As indicated by Mazzon et al and EL-Nahas et al, stone burden is not associated with achieving trifecta [8,9]. However, evidence is accumulating that stone burden is relevant to both the SFR and postoperative complications, which are 2 components of trifecta [23][24][25][26]. On the other hand, hydronephrosis degree is considered to be associated with a reduced SFR [11,27].…”

Section: Discussionmentioning

confidence: 99%

Development and assessment of a nomogram for predicting the probability of achieving trifecta in patients with urolithiasis undergoing percutaneous nephrolithotomy

Luo

Wusimanjiang

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: The trifecta standard is a newly proposed criteria for evaluating the outcome of percutaneous nephrolithotomy, which take into account the capability of different PCNL techniques to fully clear renal stones and patient comfort and quality of life. Our purpose was to develop a novel nomogram to preoperatively predict the outcomes of percutaneous nephrolithotomy (PCNL) based on the new concept, trifecta. Methods: A total of 201 patients who received PCNL between June 2021 and June 2022 were included. The least absolute shrinkage and section operator (LASSO) method was used to select the optimal predictive features, and multivariable logistic regression analysis was utilized to construct a predictive model by incorporating the factors selected with the LASSO regression model. Discrimination, calibration, and clinical usefulness of the predictive model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Result: Factors included in the nomogram were urine culture result, aciduria, maximum cross-sectional area (CSA) of stone, stone amount, stone density, number of affected calices, lower calyx affected, and hydronephrosis degree. The model exhibited promising discrimination with a C-index of 0.781, and internal validation exhibited a C-index value of 0.747. Decision curve analysis showed the nomogram was clinically useful when intervention was decided at the achieving trifecta possibility threshold of 14%. Conclusion: The nomogram developed exhibits a satisfactory predictive value for predicting the probability of achieving trifecta in patients undergoing PCNL. It may also assist in preoperative management to increase the probability of achieving trifecta. Trial registration: ChiCTR2200055385, June 2021, retrospectively registered.

show abstract

“…Forty-two (27.75%) had residual fragments of more than 4 mm size, whereas in current study low dose CT KUB done after 48 hours showed fragments >4mm in 10% of cases only. 3 …”

Section: Discussionmentioning

confidence: 99%

“… 1 Percutaneous nephrolithotomy (PCNL) is considered a surgical modality with highest stone free rate with relatively higher complication rate. 2 , 3 Post-operative imaging after stone surgeries has not been uniform. The heterogeneity of assessment is due to: modality of imaging used; X-ray alone, ultrasonography alone, X-ray and ultrasonography (USG) combined or Computed tomography (CT), timing of imaging and definition of stone free status: <2mm, <4mm or no fragments.…”

Section: Introductionmentioning

confidence: 99%

Stone Clearance by Computed Tomography after Percutaneous Nephrolithotomy: A Descriptive Cross-sectional Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Introduction: Percutaneous nephrolithotomy has the highest stone free rate among other procedures with relatively higher complication rate. Post-operative imaging after stone surgeries has not been uniform. This study was done to study about the stone clearance by computed tomography after percutaneous nephrolithotomy. Methods: The descriptive cross-sectional study was conducted in the Department of Urology, Bir Hospital for six months duration. The patients undergoing percutaneous nephrolithotomy and those with intra-operative fluoroscopic clearance were evaluated with a low dose computed tomography after 48 hours to assess residual fragments its size and location. Patient’s demographics, stone characteristics and complications were compared between the stone free and with residual stone patients. Results: Out of 72 percutaneous nephrolithotomy performed, 40 patients were included in the study. Low dose computed tomography kidney, ureter and bladder after 48 hours of surgery detected residual fragments in 11 (27.5%) patients. The RFs size of <4mm were found in 7 (63.63%) of cases whereas RFs of >4mm were found in 4 (36.36%). The stone size was 352.47 ± 97.47 mm2 and 254.79 ± 172.68mm2 in group with residual fragments and stone free group respectively. Conclusions: Low dose computed tomography kidney, ureter and bladder done for assessment of stone clearance after 48 hours of percutaneous nephrolithomy detected residual in around one fourth of patients, however majority of them had residual fragments <4mm. Intra-operative fluoroscopic clearance may over estimate stone clearance after percutaneous nephrolithomy as about one third of patients still may have residual fragments of >4mm size.

show abstract

Risk Factors for Postoperative Complications after Percutaneous Nephrolithotomy

Cited by 11 publications

References 12 publications

The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

Development and assessment of a nomogram for predicting the probability of achieving trifecta in patients with urolithiasis undergoing percutaneous nephrolithotomy

Stone Clearance by Computed Tomography after Percutaneous Nephrolithotomy: A Descriptive Cross-sectional Study

Contact Info

Product

Resources

About