Introduction and Objectives
To report the complications after or during percutaneous nephrolithotomy (PNL), according to modified Clavien grading system.
Material and Methods
A total of 911 PNLs were performed between 2006 and 2008 in our clinic, and charts were retrospectively reviewed focusing on complications observed. PNL was performed in 697 cases (76.5%), ureteroscopy followed by PNL in 110 cases (12.07%) and tubeless PNL in 104 cases (11.42%). The stone free rate achieved at 3 months postoperative was 90.56% – 825 patients. According to the modified Clavien classification system, complications were stratified into five grades. Kidney and ureteral stones treated with PNL were also classified as simple (432 – 47.42%) and complex (479 – 52.58%) and complications rates were compared.
Results
A total of 285 complications were observed in 259 (28.43%) patients. There were 48 grade 1 (5.26%), 144 grade 2 (15.8%), 54 grade 3a (5.92%), 28 grade 3b (3.07%), 6 grade 4a (0.66%) and 2 grade 4b (0.22%) complications, and 3 deaths – grade 5 (0.33%). Most of the complications were related to bleeding and urine leakage. Grade 2 and 3a complications were significantly more common in patients with complex renal stones.
Conclusions
A graded classification scheme for reporting the complications of PNL may be useful for monitoring and reporting outcomes, but for more accurate data it is necessary a prospective study.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
