Özet:

Objective: Percutaneous nephrolithotomy PNL surgery has become the gold standard treatment for many kidney stones. In this study, we aimed to evaluate the factors that affect success rate of PNL and the effect of surgical experience in PNL.Materials and Methods: Between 2005 and 2011, the records of 200 renal stone patients who underwent PNL in İzmir Atatürk Training and Research Hospital were reviewed retrospectively. Patient related factors such as age, stone size and localization were noted. Number and location of access, blood transfusion requirement, surgical experience, success rate, length of hospitalization, intraoperative and postoperative complications and additional therapy requirements were reviewed. Patients were divided into 4 groups according to surgical experience; as the as the first 50 cases, second 50 cases, third 50 cases, fourth 50 cases, respectively. Stones were classified according to kidney localization as simple... as simple single calyx or pelvic stones or complex stones choraliform, partial choraliform, pelvic + calyx stones or multiple calyx stones. Patients were evaluated with direct urinary tract X-ray on postoperative first day and with intravenous pyelography at postoperative third month.Results: Stones were located at 47.5% right side, 52.5% left side, average stone here was determined as 7.36 + 6.31 cm2 in patients who underwent PNL. 91 patients had simple stones and 109 patients had complex stones. Seventy-nine percentage 158 renal unit success rate clinically insignificant residual stone CIRF + Stone free was achieved at postoperative 1st day. There was statistically significant difference on success rate between the groups according to stone location. It was found that stone here increases, rate of success decreases p=0.002 . Additional therapy was applied 24 patients 12% , success rate was increased to 83% at postoperative 3rdmonth. Considering the influence of surgical experience, the difference was no statistically significant between four groups p=0.492 . It was found that increasing of complex stone rate effects this situation p=0.003 Complications occurred in 29% of patients who underwent PNL. Thirty-two patients required blood transfusion. 16 per cent . There was no per-operative mortality. Hydrothorax occured in 2 cases and drainage was achieved by chest tube. Mean hospitalization time was 3.61 + 2.93 days.Conclusion: PNL which needs surgical experience, can be considered as an effective and safe treatment option for renal stones with high success rates, short duration of hospitalization, and acceptable complication rates. Surgeon's experience, stone burden and stone location affect the success rate of PNL

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