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Postoperative stent and nephrostomy placement.

Postoperative stent and nephrostomy placement.

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Postoperative stent and nephrostomy placement.
Postoperative complications according to Clavien-Dindo classification.
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Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety
Article
Full-text available
  • Jul 2023
With increases in the aging population, conditions affecting older people and relevant surgical techniques are becoming more pertinent. Modified supine percutaneous nephrolithotomy (PCNL) is increasingly being adopted. There are limited data on the safety of this position in the elderly patient population. We describe our experience of the modified...
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... of the patients (50.7%) had a nephrostomy placed. Twenty procedures (29%) were tubeless (Table 2). Patients who had both nephrostomy and stent placements had a significantly longer hospital stay (p = 0.005). ...

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... Thus, an increase in the number of elderly and comorbid patients with renal stones is to be expected. Consequently, mPCNL will be more frequently performed in this population in future, with potential risk for infectious complications related to their lower overall health condition [34,35]. ...
Vacuum-assisted mini-percutaneous nephrolithotomy is associated with lower rates of infectious complications compared to vacuum-cleaner procedure in patients at high risk for infections: a single-center experience
Article
Full-text available
  • Mar 2024
  • WORLD J UROL
Purpose To evaluate the impact of vacuum-assisted mini-percutaneous nephrolithotomy (vamPCNL) vs. vacuum-cleaner mPCNL (vcmPCNL) on the rate of postoperative infectious complications in a cohort of patients with high risk factors for infections. Methods We retrospectively analysed data from 145 patients who underwent mPCNL between 01/2016 and 12/2022. Patient’s demographics, stones characteristics and operative data were collected. vamPCNL and vcmPCNL were performed based on the surgeon’s preference. High-risk patients were defied as having ≥ 2 predisposing factors for infections such as a history of previous urinary tract infections, positive urine culture before surgery, stone diameter ≥ 3 cm, diabetes mellitus and hydronephrosis. Complications were graded according to modified Clavien classification. Descriptive statistics and logistic regression models were used to identify factors associated with postoperative infectious complications. Results vamPCNL and vcmPCNL were performed in 94 (64.8%) and 51 (35.2%) cases, respectively. After surgery, infectious complications occurred in 43 (29.7%) participants. Patients who developed infectious complications had larger stone volume (p = 0.02) and higher rate of multiple stones (p = 0.01) than those who did not. Infectious complications occurred more frequently after vcmPCNL than vamPCNL (55.9% vs. 44.1%. p = 0.01) in high-risk patients. Longer operative time (p < 0.01) and length of stay (p < 0.01) were observed in cases with infectious complications. At multivariable logistic regression analysis, longer operative time (OR 1.1, p = 0.02) and vcmPCNL (OR 3.1, p = 0.03) procedures were independently associated with the risk of infectious complications post mPCNL, after accounting for stone volume. Conclusion One out of three high-risk patients showed infectious complications after mPCNL. vamPCL and shorter operative time were independent protective factors for infections after surgery.
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