Abstract:

Introduction and Objective: In this study, a surgeon who starts PNL for the first time after specialization in the 2nd stage state hospital was intended to evaluate the results of the first 60 cases considered to have reached the qualification in this surgery as retrospective and evaluate that PNL can be started safely and effectively in the 2nd stage hospitals. Method and Requirements: 60 renal units (58 patients) with percutaneous nefrolitotomy were included in the study. All patients were applied standard (30Fr) percutaneous nefrolithotomy in prone position with 25Fr rhythic nefroscope and pneumothic litotriptor. Data related to the patient, such as age, gender, the operated side, the stone load, the number of stones, the localization of the stone, the localization of renal access and the number, the duration of the operation, the gradual complications, the need for blood transfusion, the rate of success, the duration of the stay in the hospital and the additional treatment requirements were collected retrospectively. 43 (74%) of patients were male, 15 (26%) female and the average age was 47.8 ± 10.5 (22-67) 20 of the stones (33.3%) were simple stones, while 40 (66.7%) were complex stones. The average stone load was 8.4 cm2 and the average Hounsfield Unit (HU) was 1121 ± 267. The average duration of the surgery was 125 ± 34 minutes. Patients were sleeping in the hospital for an average of 4.4 ± 2 (2-12) days. In 26.7 percent of the renal units there were complications, while in Clavien grade 4 and grade 5 there were no complications. With additional efforts, 90% success has been achieved (depletion + clinically unimportant residual fragments). PROPOSITION AND RESULTS: PNL is considered to be able to start with complications and success rates in a safe and effective way in state hospitals of stage 2 and the subject needs prospective randomized controlled studies.

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