Upper Pole Urologist-Obtained Percutaneous Renal Access for PCNL is Safe and Efficacious: Kenneth Ogan
Upper pole percutaneous access for PCNL may provide access to stone-containing calyces and lead to higher stone-free rates; however, upper pole access may be associated with an increased risk for complications such as pleural injury. To evaluate these risks and benefits, Dr. Ogan and colleagues performed a retrospective review of PCNL cases at their institution and they presented their findings in this ePoster.
From 2003 to 2014, the authors reported a total of 144 PCNL cases performed in which upper pole access was gained by two experienced endourologists at their institution. Clinical variables such as operative time, change in hemoglobin, and post-operative complications were analyzed. Stone-free status following PCNL was also evaluated and stone-free was defined as no stones >4mm on CT scan on post-operative day 1.
Their results of this review revealed that upper pole access was obtained above the 12th rib in the majority of cases (57.6%) while access above the 11th rib was obtained in 18 cases (12.5%). Stone-free rates were 64.6% with only 35 patients (24.3%) requiring additional PCNL procedures. Overall, the post-operative complication rate was 12.5% with hydropneumothorax occuring in 8 patients requiring chest tube placement. Average length of hospital stay was 2.5 days. The authors concluded from their findings that upper pole access for PCNL was associated with acceptable stone-free rates and complication rates.
Presented by Kenneth Ogan at the 2015 World Congress of Endourology Annual Meeting – October 1-4, 2015, London, United Kingdom.
Written by Kyle Spradling for UroToday.com.