Pakistan Journal of Medical Sciences


ISSN 1681-715X





Volume 25

 April - June 2009 (Part-II)

Number 3


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Decreasing the complications of PCNL with
alternative techniques including complete supine
PCNL and subcostal approach

Siavash Falahatkar1, Iradj Khosropanah2, Zahra Atrkar Roshan3,
Mahboobeh Golshahi4, Seyedeh Atefeh Emadi5


Objectives: To assess the incidence of complications during percutaneous nephrolithotomy.

Methodology: We studied the files of patients at our urology research center in Rasht, Iran from 2007-2008. One hundred and seventy four patients with symptomatic renal and upper ureteric calculi were selected with the technique of non-probability convenient sampling. Complications of surgery were evaluated and divided into 3 categories: peri-operative, early, and late complications of surgery. Perioperative complications included bleeding, transfusion, extravasation, and injury to adjacent organs. Early complications following surgery included post operative bleeding, post operative transfusion, extravasation, infection, and residual stones. Late complications included injury to adjacent organs. All patients were subjected to PCNL. The data was analyzed on SPSS version 10.

Results: Regardless of position, the pelvicaliceal system could be successfully approached in all patients. The mean age of patients was 44.71 13.16 years. The mean stone size in was 26.64 14.39 mm. The mean operation time was 95.14 26.57 minutes. The stone free rate was 85.7%. Peri operative complications included transfusion due to bleeding 5.7%, and extravasation 3.4%. Early complications included transfusion due to bleeding 5.1%, extravasation 2.3%, infection 2.9% and residual calculi 14.3%. Late complications were not seen. No mortality was recorded. The most common stone site was pelvic stone (34.4%). Stone sites in 45.9% of our patients was in the right kidney while 54.1% was left-sided.

Conclusions: PCNL is a valuable treatment option for kidney stones. Potential advantages include less hospital stay with lower cost, lower discomfort and pain, and a lower complication rate. Also PCNL can be applied to many patients with kidney stones. We recommend a subcostal approach and also the use of complete supine PCNL (csPCNL) in decreasing the complications of PCNL.

KEY WORDS: Lithotripsy, Urinary calculi, Postoperative complications, Complete supine PCNL (csPCNL), Subcostal approach.

Pak J Med Sci    April - June 2009 (Part-II)     Vol. 25 No. 3    353-358

How to cite this article:

Falahatkar S, Khosropanah I, Roshan ZA, Golshahi M, Emadi SA. Decreasing the complications of PCNL with alternative techniques including complete supine PCNL and subcostal approach. Pak J Med Sci 2009;25(3): 353-358.

1. Siavash Falahatkar
Associate Professor,
2. Iradj Khosropanah MD,
Assistant Professor
3. Zahra Atrkar Roshan, MS
4. Mahboobeh Golshahi, MD
5. Seyedeh Atefeh Emadi, MD
1-5: Guilan University of Medical Sciences,
Urology Research Center,


Siavash Falahatkar
Sardar Jangal Street,
Razi Hospital, Rasht Iran.

* Received for Publication: January 09, 2009
* Revision Received: May 14, 2009
* Revision Accepted: May 15, 2009


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