ROLE OF MINI PCNL IN THE TREATMENT OF RENAL AND UPPER URETERIC CALCULUS.

Corresponding Author:
Dr. J. Sasi Kumar,
Professor,
Department of Urology,
Mamata Medical College,
Khammam,
Telangana, India.
E-mail: jonnalagaddasasikumar@gmail.com

ABSTRACT

BACKGROUND

In this article we describe our institutional experience with mini PCNL, in particular the indications, results and the complications of this method.

MATERIALS AND METHODS

It is a prospective observational study. We prospectively reviewed the outcomes of 54 patients who underwent mini-PCNL in our institute from January 2018 to November 2018. Mean age was 47.2 years and mean stone size was 18.4 mm. Hydronephrosis and/or hydroureterosis appeared in all patients. In the prone position, percutaneous access (18-Fr Amplatz sheath) was established by placement of an access needle into the intended calyx under fluoroscopic guidance with single step dilatation. Pneumatic lithotripter was used for fragmentation. The ureteral stents and nephrostomy tube were placed at the end of the procedure in all patients. Mean drop in haemoglobin, transfusion rate, operative time, success rate, hospital stay, and complications were assessed.

RESULTS

Mini-PCNL operations were performed successfully in all patients. Mean operation time was 48.4 min. Mean postoperative hospital stay was 54 hours. No major complications like haemorrhage, perforation or organ injury was noted during the operation or postoperatively. The stone-free rate in upper ureteric calculi was 100% and for renal calculi it was 93.1% and for both it was 100%. Hydronephrosis and hydroureterosis disappeared or were relieved and mean haemoglobin drop was 0.8%.

CONCLUSION

Mini-PCNL is a safe and effective therapy for proximal ureteral stones and renal calculi up to 2 cms and multiple calyceal calculi.

KEY WORDS

Mini PCNL, PCNL, Upper Ureteric Calculus, Renal Calculus.