Munich, Germany (UroToday.com) With the increasing incidence and prevalence of stone disease, the number of percutaneous nephrolithotomy (PCNL) procedure is increasing in parallel. PCNL is a complex surgical procedure which traditionally requires hospitalization of the patient and an expert surgical team and equipment. Agudelo and authors performed a pilot study to evaluate the safety of this procedure on an outpatient setting.
Material & Methods
The study analyzed only patints who were eligible and underwent ambulatory PCNL. Inclusion criteria was ASA class < 3, patients without congenital malformations, renal insufficiency or retained catheters. Additionally, intraoperative factors were taken into consideration; not more that 3 punctures for their access, multiple tracts, or significant residual stones. Furthermore, pyelocaliceal perforation or excessive bleeding should not be observed. Postoperatively, the patient had to be hemodynamically stable, with a hematocrit> 30, pain control and normal chest radiograph.
Overall 52 patients were carefully selected to unergo ambulatory PCNL. All procedures were performed in the prone position. Of these, 39 were discharged home at the same postoperative day. Mean surgical time was of 105 minutes, including cystoscopy. Stone free rate was 92.3% (36 patients), and ancillary procedures were only used in 2 cases. No patients required secondary admission.Authors concluded that ambulatory PCNL is feasible and safe in highly selected patients. It has a good safety and efficacy.
Presented By:
Agudelo J.A.
Hospital Coromoto De Maracaibo, Dept. of Urology, Maracaibo, Venezuela
Reported by
Zhamshid Okhunov, MD, at the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany
UC Irvine Urology