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Organo Oficial de la Sociedad Mexicana de Urología

2021, Number 4

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Rev Mex Urol 2021; 81 (4)

Percutaneous renal surgery, first experience at the Hospital General de Morelia “Dr. Miguel Silva”

Ponce de León-Ballesteros F

Language: Spanish
References: 17
Page:
PDF size: 139.18 Kb.


ABSTRACT

Background: The first reports of percutaneous nephrolithotomy date back to 1941, when Rupel and Brown performed the extraction of a pyelic stone by introducing an endoscope through a mature nephrostomy tract. Over the years, multiple improvements have been made in the equipment used, variations in the positions of the patients for a better approach, a decrease in the diameter of the tract, currently being considered by the European and North American guidelines as the treatment of first choice for kidney stones.
Primary Objective: show the experience in this type of surgery after its introduction in the Urology Department in a second level hospital.
Secundary Objetives: To evaluate the safety and efficacy of percutaneous renal surgery in a hospital where open surgery is traditionally performed for the treatment of renal lithiasis.
Materials and methods: A retrospective study is carried out in patients undergoing Percutaneous Renal Surgery (PCNL) at the General Hospital of Morelia of the Ministry of Health between February 2011 and March 2012. Surgical time, complications, days of hospital stay, percentage of residual lithiasis and fluoroscopy time.
Results: Sixty four patients were studied, of which 41 (64%) were male and 23 (36%) female; average age of 34 years; 13 (20.31%) patients with staghorn stones, 20 (31.25%) with stones in several calyces and 31 (48.43%) with single stones, 10 (15.62%) patients with bilateral stones; calculation free rate 87.5%; The complications presented according to the Claiven-Dindo was 14%; average fluroscopy time of 2.2 minutes.
Conclusions: Percutaneous nephrolithotomy is a surgical technique that, despite being considered the treatment of choice for kidney stones, is still little performed in provincial medical centers. To carry it out, training in endourology of the surgeon, persistence, and conviction of the rest of the surgical service, anesthesiologists and hospital managers of the benefits granted to the patient in the treatment of lithiasis as well as economic benefits to the institution is required. Percutaneous renal surgery is a safe surgery, with a high success rate, rapid patient recovery and shorter hospital stay.


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