TY - EJOU AU - Cho, Hyuk Jin AU - Lee, Ji Youl AU - Kim, Sae Woong AU - Hwang, Tae-Kon AU - Hong, Sung-Hoo TI - Percutaneous nephrolithotomy for complex renal calculi: is multi-tract approach OK? T2 - Canadian Journal of Urology PY - 2012 VL - 19 IS - 4 SN - 1488-5581 AB - Introduction: To compare the safety and efficacy of multiple-tract percutaneous nephrolithotomy (PCNL) with single-tract PCNL for complex renal stones.
Materials and methods: A total of 109 consecutive PCNL procedures for unilateral complex renal calculi (staghorn or complex caliceal calculi) were performed at our institution. Thirty patients received multiple-tract PCNL and 79 patients underwent single-tract PCNL. The two groups had comparable demographic data, except for a smaller stone burden and fewer complete staghorn calculi in those undergoing single-tract PCNL. Variables of interest included operative time, blood loss, change in serum creatinine, transfusion rates, length of hospital stay, stone clearance, number of ancillary procedures, and complication rates.
Results: The number of tracts used for multiple-tract PCNL was two in 20 patients, three in 9, and four in 1. No significant differences were observed when comparing single-tract PCNL with multiple-tract PCNL in terms of success rate, operative time, transfusion rate, drop in hemoglobin, hospitalization time, complication rate, or rise in serum creatinine. However, the need for ancillary procedures was more common in patients undergoing multiple-tract PCNL (53.3% versus 24.1%; p = 0.003). No long-term sequelae were noted during the median follow-up of 24 months in any patient.
Conclusions: The results of the present study show that multi-tract PCNL for appropriately chosen stones/patients has similar safety and effectiveness as single-tract PCNL in patients with smaller and less complex stones. KW - percutaneous nephrolithotomy KW - kidney calculi KW - treatment outcome KW - complications DO -