Day-surgery percutaneous nephrolithotomy: a high-volume center retrospective experience
Percutaneous nephrolithotomy (PCNL) is traditionally performed on an inpatient basis. We determine the safety and outcome of day-surgery PCNL by experienced surgeon hands.
Patients and methods
A protocol for day-surgery PCNL was undertaken. A retrospective analysis of all 86 cases of planned day-surgery PCNL accomplished by an experienced surgeon who followed this protocol between May 2017 and March 2019 was performed. Patient demographics, operative data, complications, and readmission rates were recorded. Day-surgery PCNL was defined as discharge of patients either the same day or within 24 h after surgery.
The average stone burden was 361.1 mm2 and 70 (81.4%) of patients had multiple stones or staghorn stones. 82 (95.4%) patients achieved same-day discharge or received overnight observation prior to discharge, and 4 patients (4.6%) required full admission (longer than 24 h). The readmission rate was 2.3% (2 patients). The postoperative complications occurred in 10 (11.6%) patients, including 7, 2, 2 of grade I, II, III complications. The average operation time was 64 min and the hemoglobin drop was 15.7 ± 16.9 g/L. The established tracts size ranged from 16 to 22Fr. The stone clearance rate was 90.7%. The tubeless without nephrostomy tube was performed in 60.5%. Eight cases were performed by multiple-tracts PCNL with 2–4 tracts, with only two case required full admission.
Experienced surgeons who performed day-surgery PCNL experience excellent patient outcomes in appropriately selected patients. Most complications can be treated conservatively and only a few required intervention or readmission.
KeywordsPercutaneous nephrolithotomy Day-surgery PCNL Multiple tracts Staghorn stone Outcomes
YL had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: GZ, YL. Acquisition of data: XW, ZZ, HS, ZL, HZ, DC, CC. Analysis and interpretation of data: XW, ZZ. Drafting of the manuscript: ZZ, XW. Critical revision of the manuscript for important intellectual content: ZZ, YL. Statistical analysis: XW. Supervision: GZ, YL. Other: none.
This study was supported in part by National Natural Science Foundation of China (No. 81600542). Additional funding was provided by Guangzhou Science Technology and Innovation Commission (Nos. 201604020001 and 201704020193). The project of Health and Family planning Commission of Guangzhou Municipality(No. 20181A010051).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Yongda Liu certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None.
Informed consent was obtained from all individual participants included in the study.