M.M. Chaplya

Percutaneous nephrolithotomy in the treatment of nephrolitiasis and the structure of pcnl complications

In this article results of treatment of 1952 patients with urolithiasis, who underwent 2218 percutaneous nephrolithotomy. All patients were examined using common laboratory and instrumental methods of diagnosis. The presence of stones confirmed the clinically, radiographically and by ultrasound. In 1386 (62.3%) cases plain urography was performed and in 1332 cases - excretory urography. In 823 cases (37.7%) patients was performed computed tomography with contrast enhancement and in 14 cases without contrast enhancement, so there were no need to repeat the plain and excretory urography. Pelvic stones were observed in 638 cases. Multiple stones were found in 856 cases. Staghorn nephrolithiasis was diagnosed in 729 cases: I stage staghorn stone - 286 cases, II stage staghorn stone - 211 cases, staghorn stone of III stage - 194, staghorn stone of the fourth stage - 38. Hydronephrotic transformation were observed in 1126 (50.6%) cases. Percutaneous nephrolithotomy applied after the liquidation of acute and activation of chronic inflammation in the kidneys. Operation was performed using endotracheal anesthesy in 317 (14,3%) cases and in 1906 (85,7%) - under peridural anesthesy.

1594 (81,7%) patients were rendered stone-free with the PCNL method .

In our study, complications of percutaneous nephrolithotomy were observed in 507 cases, accounting 22.8%.

All complications were distributed under a modified Clavien-Dindo scale. Among all the complications dominates side effects of Ist group by Clavien classification (178 cases). Postoperative mortality of patients after percutaneous nephrolithotomy 0.13% cases.