AMBULATORY MINI PERCUTANEOUS NEPHROLITHOTOMY (MINI-PCNL): FEASIBILITY AND OUTCOMES IN 1000 CASES IN PAKISTAN

  • Qamar Zia Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Faran Kiani Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mudassar Sajjad Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Nawaz Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Akmal Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Adil Khurshid Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Asma Rizwan Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Muzzammil Ali Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Keywords: Ambulatory care facility, Hematuria, Kidney stones,, Percutaneous nephrolithotomy, Renal calculi, Therapeutic chemoembolization, Thoracotomy

Abstract

Objective: To review the outcomes of a consecutive cohort of 1000 patients with renal stones managed with mini-percutaneous nephrolithotomy at our institute.

Study Design: Prospective observational study.

Place and Duration of Study: Armed Forces Institute of Urology Rawalpindi, Pakistan, from Jan 2016 to Dec 2018.

Methodology: Surgery was carried out under general anesthesia in prone position. Access was made by single step dilatation by 14-17 French sheath, pneumatic lithoclast was used for stone disintegration and fragments removed. Foley and ureteric catheters were removed following morning of surgery after confirming stone clearance on plain X-Ray kidney ureter and bladder.

Results: Mean stone size was 3.1 ± 2.1cm (2-6). Upper pole access was utilized in 398 (39.8%) while lower pole in 587 (58.7%) cases. Mean operative time was 67 ± 15.4 minutes (45-120) while the mean hospital stay was 22 ± 13.2 hours (20-120). A complete clearance rate of 93.3% was achieved as assessed by plain X-Ray kidney ureter & bladder. Residual stones were treated with either shock wave lithotripsy or redo mini-Percutaneous Nephrolithotomy. 910 (91%) of patients were discharged within 24 hours of surgery.

Conclusion: Mini Percutaneous nephrolithotomy was found as a safe and feasible alternative contemporary established technique for treatment of nephrolithiasis which can be offered as a day case surgery except for complete staghorn calculi.

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Published
2020-04-30
How to Cite
Zia, Q., Kiani, F., Sajjad, M., Nawaz, M., Akmal, M., Khurshid, A., Rizwan, A., & Ali, M. (2020). AMBULATORY MINI PERCUTANEOUS NEPHROLITHOTOMY (MINI-PCNL): FEASIBILITY AND OUTCOMES IN 1000 CASES IN PAKISTAN. Pakistan Armed Forces Medical Journal, 70(2), 469-73. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/4213
Section
Original Articles