MANAGEMENT OF COMPLICATIONS SECONDARY TO POST SUPRACOSTAL MINI PERCUTANEOUS NEPHROLITHOTOMY

Abstract

Objectives:  The objective of the study is to share experience of management of complications secondary to supracostal mini percutaneous nephrolithotomy (PCNL) in tertiary care hospital.

Methods: : This is retrospective study conducted in department of urology Khalifa Gul Nawaz teaching hospital Bannu from January 2018 to December 2020, age ranges from 14 years to 56 years, ⁹2 patients have right kidney stones and 68 has left side, 103 were male and 57 were female. All procedure was performed through supracostal single puncture. Mean size of stone range from 2.6 ± 1.2cm.

Results: Patients with supracostal mini PCNL were divided into 3 groups depend upon the access to kidney through intercostal space. Group 1 access between 11^th and 12^th rib, group 2 access between 10^th and 11^th rib and group 3 access between 9^th and 10^th rib. Among 12 patients who developed hydrothorax 4.3% (7) patients were managed conservatively 2.5% (4) patients needed needle aspiration while single patient undergone chest intubation in main operation theater. 1.25% (2) patients had bleeding intraoperative and managed conservatively with blood transfusion. 1.8 % (3) patients had urosepsis and presented after 2 days of discharge from hospital and managed with intravenous empirical antibiotic.

Conclusion: The management of complications secondary to supracostal mini PCNL depends upon the vital signs, symptoms of patient, type and amount of fluid in the pleural space. The complications encountered with supracostal mini PCNL can be diagnosed and safely managed in urology ward in close collaboration with other specialized units.