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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone
Urology, Volume 79, No. 6, Year 2012
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Description
Objective: To determine factors affecting the stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. Methods: The computerized database of patients who underwent PNL for treatment of staghorn stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting stone-free and complication rates. Results: The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral stones). The stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual stones were complete staghorn stone and presence of secondary calyceal stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Conclusion: Factors affecting the incidence of residual stones after PNL are complete staghorn stones and the presence of secondary calyceal stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive. © 2012 Elsevier Inc. All Rights Reserved.
Authors & Co-Authors
El-Nahas, Ahmed Refat
Egypt, Mansoura
Faculty of Medicine
Eraky, Ibrahim A.
Egypt, Mansoura
Faculty of Medicine
Shokeir, Ahmed Abdulrahman
Egypt, Mansoura
Faculty of Medicine
Shoma, Ahmed M.
Egypt, Mansoura
Faculty of Medicine
El-Assmy, Ahmed M.
Egypt, Mansoura
Faculty of Medicine
El-Tabey, Naser A.
Egypt, Mansoura
Faculty of Medicine
Soliman, Shady A.
Egypt, Mansoura
Faculty of Medicine
Elshal, Ahmed Mohamed
Egypt, Mansoura
Faculty of Medicine
El-Kappany, Hamdy A.
Egypt, Mansoura
Faculty of Medicine
El-Kenawy, Mahmoud R.
Egypt, Mansoura
Faculty of Medicine
Statistics
Citations: 104
Authors: 10
Affiliations: 1
Identifiers
Doi:
10.1016/j.urology.2012.01.026
ISSN:
00904295
e-ISSN:
15279995
Study Design
Cohort Study
Participants Gender
Male
Female