The immediate major complications of percttaneous surgery of the upper urinary tract (PCN): Our experience

Vinceiizoni Andrea, Cassaneni Antonella, Schettini Manlio, Gallucci Michele

Research output: Contribution to journalArticle

Abstract

OBJECTIVES Although urologists have been using PCN for more than 15 years there are slill a number of problems. The aim of this study is to evaluate the impact that major complications have after 10 years experience. MATRRIALS AND METHODS: from 1984 to 1995 we earned out 897 PCN operations. 741(83%) for pyelo-calicial stones. 37 (4.2%) for ureterolumbar stones, 66 (7.3%) for endopyelotomy, 15 (1.7%) diagnostic. 16 (1.8%) prosthesis implants for ureteral occlusion and 18 (2%) for the recanalization of the uretero-intestinal anastomosis. The technique of percutaneous access was the same in all cases: puncture wiih a Marberger needle, dilation with an Alken telescopic dilator, nephroscope 20Ch for endopyelotomy and 24Ch for the remaining cases. Manitol and serbitol were used for irrigation solutions for the endopyelotomies only at the time of thermocoagulation. In all the other cases physiological solution was used. A nephrostomic catheter was left for a minimum of 3 days, 16Ch for endopyelotomy and 22Ch for the remaining cases. Major complications were classified according to the following criteria: during access, intraoperative and postoperative. RESULTS: the complications during acces were 1 uro-colfc fistula and 1 artero-venous fistula, the intraoperative complications were: 1 complete pyelo-ureteral junction detachment and 2 forcep breakages during the extraction of the calculi. Postoperative complications were: 2 massive pulmonary embolisms, 4 septic shock with 1 multi organ failure ( MOF) and 18 bleeding which required autologus blood transfusions. CONCLUSIONS: after 10 years' experience we may affirm that the percutaneous technique has fewer complications than open surgery and therefore preferable because of the advantages tothe patients, nonetheless the complications may be serious and PCN should always be practised by welltrained surgeons and in oplimum operative conditions.

Original languageEnglish
Pages (from-to)329
Number of pages1
JournalBritish Journal of Urology
Volume80
Issue numberSUPPL. 2
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Urology

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