Objectives: The aim was to assess how the monoplanar fluoroscopy guided access affect the
outcomes of percutaneous nephrolithotomy (PCNL).
Methods: This retrospective study included all patients who had renal stones and underwent
prone PCNL using monoplanar fluoroscopy guided access in a single tertiary care center
between January 2015 and January 2024. Preoperative and postoperative patient and
procedure related variables such as operative time, intraoperative blood loss, number of
tracts, complications, stone-free rate (SFR), and hospital stay were assessed. Multivariable
analysis was performed to detect predictors of residual stones and complications.
Results: A total of 662 patients with an average age of 47±12 years were included. Comorbidities were reported in 26.1%. ASA score was I in 64.8%. The mean stone diameter
was 2.8±0.9 cm. Only 6% had positive preoperative urine culture. The mean stone HU was
1054±304 with a mean operative time of 94±31 minutes. Most of cases (74.9%) required only
one tract. Postoperative fever was reported in 22.4%. The median estimated blood loss (EBL)
was 160 mL. The complications included urine leak (4.1%), blood transfusion (1.5%), sepsis
(1.5%), renal pelvic perforation (0.8%), superselective angio- embolization (0.6%), pleural
injury (0.6%), and colonic injury (0.2%). The median hospital stay was three days.
Approximately, 73% were stone free. The only predictor of residual stone was higher stone
diameter (OR=1.536, p=0.001). Predictors of complications were three tracts (OR=4.501,
p=0.033) and higher EBL (OR=1.003, p < 0.001).
Conclusions: The monoplanar fluoroscopy guided approach has demonstrated a noteworthy
success rate, rendering it a safe modality for prone conventional PCNL. |
