Category: Clinical Stones: PCNL
Introduction & Objective :
Percutaneous nephrolithotomy (PCNL) can be challenging in patients with neurologic disease, sometimes due to their body habitus and/or spinal cord abnormalities.
The aim of the study was to evaluate the safety and efficacy of percutaneous nephrolithotomy for renal stones in patients with neurologic disease including patients with severe motor disability.
Between 2005 and 2017, we retrospectively analyzed 76 PCLN procedures to treat 68 kidneys in 54 patients.
Stone Free (SF) kidneys was considered as a success and was defined as an absence of stones on computerized tomography, renal ultrasound or per-operative constatations.
Early post-operative complications were reported according to Clavien-Dindo classification.
The succes rate was 60,5%. For 15,8% of procedures, this goal was achieved in 2 times, and for 35,5%, a new procedure was necessary within 3 years.
Seven (9,2%) severe complications (Clavien Dindo>2) occurred including death for 3 (3,9%). 26 minor complications occurred (34,2%).
The main complication was urosepsis occurring in 31,6% of cases (n=24). Blood transfusions were needed for 18,4% of cases (n=14).
PCNL is a challenging procedure in patients with neurological disease sometimes due to modified anatomy and installation constraints.
Low grade complication is frequent.
In this specific population, the goal is to attain a minimum residual stone burden in a single safe procedure.
This may explain the modest succes rate (SF) which is lower compared to overall population.