Complications of percutaneous nephrolithotomy as treatment for staghorn renal stone

Authors

Keywords:

urolithiasis, nephrolithotomy percutaneous, intraoperative complications, postoperative complications, staghorn calculi.

Abstract

Introduction: Percutaneous nephrolithotomy is the first therapeutic option for staghorn kidney stones.
Objective: To characterize patients with complications of percutaneous nephrolithotomy for the treatment of staghorn renal lithiasis.
Method: A series of 191 patients, operated by percutaneous nephrolithotomy, was studied. Variables studied: type of staghorn lithiasis, position for the technique, stone-free condition after the operation, presence of complications, time, type and grade according to the Clavien-Dindo classification. Absolute and relative frequencies were found and the chi-square test was used to determine the association between variables.
Results: 86.9 % were less than 60 years old, 67,0 % were male, 61,7 % had comorbidities. The staghorn lithiasis was partial or total (30,3 % and 46,5 %, respectively). In 60,2 % it affected the left kidney; 58.1 % underwent supine surgery and 70,2 % were stone free with monotherapeutic percutaneous nephrolithotomy. Complications occurred in 19,9 %; 16,2 % were postoperative, 14,1 % infectious, 7,8 % Clavien-Dindo I, and 5,2 % IIIb. The type of lithiasis and the position of the percutaneous nephrolithotomy were not associated with complications (p> 0,05). The degree of complication was not related to the type of lithiasis (p> 0,05).
Conclusions: The most frequent postoperative complications are those related to infection and bleeding; they slightly predominate in patients with partial and total staghorn stones and in those operated on in the supine position; the Clavien-Dindo grade of complications is only slightly higher in the more complex staghorn stones.

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Author Biographies

Mariano Castillo Rodríguez, Hospital Universitario Hermanos Ameijeiras

J Unidad de Litotricia y Endourología

Tania González León, Centro Nacional de Cirugía de Mínimo Acceso

J Departamento Urología Centro Nacional de Cirugía de Mínimo cceso

Angela Rosa Gutiérrez Rojas, Hospital Universitario Hermanos Ameijeiras

J Departamento de Investigaciones

Luis Leandro Borrero Barrientos, Hospital Universitario Hermanos Ameijeiras

Especialista de Urología

María Victoria Labrada Rodríguez, Hospital Universitario Hermanos Ameijeiras

Prof Consultante de Urología

Ana Ramírez Mena, Especialista de Urología

Especialista de Urología

References

1. Gadzhiev N, Malkhasyan V, Akopyan G, Petrov S, Jefferson F, Okhunov Z. Percutaneous nephrolithotomy for staghorn calculi: Troubleshooting and managing complications. Asian J Urol. 2020; 7(2):139-48. DOI: 10.1016/j.ajur.2019.10.004.

2. Gadzhiev NK, Obidnyak VM, Gorelov DS, Malkhasyan VA, Akopyan GN, Mazurenko DA, et al. Complications after PCNL: diagnosis and management. Urologiia. 2020 [acceso: 14/06/2021]; (5):139-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33185362/

3. Malkhasyan VA, Semenyakin IV, Ivanov VY, Sukhikh SO, Gadzhiev NK. Complications of percutaneous nephrolithotomy and their management. Urologiia. 2018 [acceso: 11/07/2021]; (4):147-53. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30761806/

4. Pradère B, Doizi S, Proietti S, Brachlow J, Traxer O. Evaluation of Guidelines for Surgical Management of Urolithiasis. J Urol. 2018; 199(5):1267-71. DOI: 10.1016/j.juro.2017.11.111

5. Wollin DA, Preminger GM. Percutaneous nephrolithotomy: complications and how to deal with them. Urolithiasis. 2018; 46(1):87-97. DOI: 10.1007/s00240-017-1022-x

6. Arora AM, Pawar PW, Tamhankar AS, Sawant AS, Mundhe ST, Patil SR. Predictors for severe hemorrhage requiring angioembolization post percutaneous nephrolithotomy: A single-center experience over 3 years. Urol Ann. 2019; 11(2):180-86. DOI: 10.4103/UA.UA_75_18

7. Palmero JL, Nuño de la Rosa I, Miralles J, Amorós A, Pastor JC, Benedicto A. Study of predictive factors for complications after percutaneous nephrolithotomy according to the Clavien classification. Actas Urol Esp. 2013; 37(7):412-8. DOI: 10.1016/j.acuro.2012.11.006

8. Omer Rashid A, Khalid H, Friad G, Hamed RY, Buchholz N. Guy's Stone Score as a predictor for stone-free rate and complications in percutaneous nephrolithotomy: A single-center report from a Stone Belt Country. Urol Int. 2020; 104 (9-10): 746-51. DOI: 10.1159/000506211

9. Wagenius M, Borglin J, Popiolek M, Forsvall A, Stranne J, Linder A. Percutaneous nephrolithotomy and modern aspects of complications and antibiotic treatment. Scand J Urol. 2020; 54(2):162-70. DOI: 10.1080/21681805.2020.1740316

10. Castillo GF, Monzón RJC, López MRS, Hernández P, Morera I, Mendoza L. Cirugía percutánea de la litiasis renal. Experiencia inicial. Acta Med Cent. 2012 [acceso: 10/05/2021]; 6(1): 7p. Disponible en: https://revactamedicacentro.sld.cu/index.php/amc/article/view/669

11. Fernández García A, Toledo Viera A, Carreño Rodríguez J, González Martín R, Moreno Segismundo J, Fernández Aportela O, et al. Percutaneous nephrolithotomy in supine decubitus. Valdivia's position. Arch Esp Urol. 2009 [acceso: 10/05/2021]; 62 (4): 289-93. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19717878/

12. De La Concepción Gómez O, Sánchez Tamaki R, Reyes Arencibia R, Rojas Fiel I, Pérez Delgado J, Muradas Aujier M, et al. Experiencia en la nefrolitotomía percutánea en el Instituto de Nefrología. Rev. Cubana Urol. 2013 [acceso: 10/05/2021]; 2(2): 1. Disponible en: https://www.revurologia.sld.cu/index.php/rcu/article/view/91

13. Blanco Borrero D, González León T, Suárez Marcillán M, Torres Fuentes G, Rodríguez Samada E, Perdomo D. Cirugía renal percutánea. Experiencia en el CNCMA. Rev. Cubana Urol. 2013 [acceso: 10/05/2021]; 2(2): 1p. Disponible en: https://www.revurologia.sld.cu/index.php/rcu/article/view/97

14. Torrecilla C, Vicéns-Morton AJ, Meza IA, Colom S, Etcheverry B, Vila H, et al. Complications of percutaneous nephrolithotomy in the prone position according with modified Clavien-Dindo grading system. Actas Urol Esp. 2015 [acceso: 11/07/2021]; 39 (3): 169-74. Disponible en: https://www.elsevier.es/en-revista-actas-urologicas-espanolas-292-articulo-complicaciones-nefrolitotomia-percutanea-decubito-prono-S0210480614003386

15. Wollin DA, Joyce AD, Gupta M, Wong MYC, Laguna P, Gravas S, et al. Antibiotic use and the prevention and management of infectious complications in stone disease. World J Urol. 2017; 35(9):1369-79. Disponible en: DOI: 10.1007/s00345-017-2005-9

16. El-Nahas AR, Nabeeh MA, Laymon M, Sheir KZ, El-Kappany HA, Osman Y. Preoperative risk factors for complications of percutaneous nephrolithotomy. Urolithiasis. 2021; 49(2):153-160. DOI: 10.1007/s00240-020-01203-9

17. de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012; 62(2):246-55. DOI: 10.1016/j.eururo.2012.03.055

18. Joshi R. Complications and success rate of percutaneous nephrolithotomy in renal stone: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2019; 57(220):444-48. DOI: 10.31729/jnma.4723

19. Li J, Gao L, Li Q, Zhang Y, Jiang Q. Supine versus prone position for percutaneous nephrolithotripsy: A meta-analysis of randomized controlled trials. Int J Surg. 2019; 66:62-71. DOI: 10.1016/j.ijsu.2019.04.016

20. Klein I, Gutiérrez-Aceves J. Preoperative imaging in staghorn calculi, planning and decision making in management of staghorn calculi. Asian J Urol. 2020; 7(2): 87-93. DOI: 10.1016/j.ajur.2019.07.002

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Published

2021-11-15

How to Cite

1.
Castillo Rodríguez M, González León T, Gutiérrez Rojas AR, Borrero Barrientos LL, Labrada Rodríguez MV, Ramírez Mena A. Complications of percutaneous nephrolithotomy as treatment for staghorn renal stone. Rev Cubana Med Milit [Internet]. 2021 Nov. 15 [cited 2025 Jan. 11];50(4):e02101639. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1639

Issue

Vol. 50 No. 4 (2021): October - December

Section

Research Article

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