[The analysis of perioperative complications of percutaneous nephrolithotomy in the treatment of nephrolithiasis with the use of modified Clavien-Dindo classification].

UNLABELLED

The improvement of surgical care requires transparent, consistent and accurate reports concerning surgical outcomes which are assessed and documented in a standardized manner. No consensus has yet been reached as to how to define and assess postoperative complications with regard to the specificity of urological procedures. Therefore, the comparison of data from different centres is difficult. The modified Clavien-Dindo classification allows for a more uniform analysis of surgical complications. This study analyses the occurrence of perioperative complications after percutaneous nephrolithotomy assessed on the basis of the aforementioned classification.

AIM

The aim of this study was to analyse perioperative complications with the use of modified Clavien-Dindo classification. Obtained results were compared with those from the multicentre Endourological Society Percutaneous Nephrolithotomy Global Study.

MATERIALS AND METHODS

This retrospective analysis involved 201 patients who underwent percutaneous nephrolithotomy during the period from 01.01.2013 to 31.12.2016. We assessed the frequency of complication and the characteristics of deposits. The modified Clavien- Dindo classification was used here. The surgery was performed by one operator in one centre.

RESULTS

In 83.08% of patients normal postoperative course was reported. In case of 12.44%, there were minor deviations from the standard intraoperative and postoperative course. 2,49% of patients required transfusions of red blood cell (Clavien II) after the procedure. Less than 1.5% of patients required surgical, endoscopic or radiological intervention under local anaesthesia (Clavien IIa) and one patient required such intervention under general anaesthesia (Clavien IIb). Serious complications were not reported. The most common complications were as follows: low-grade fever (15.42%), fever (5.97%) and bleeding (3.48%). Among the least frequent complications there were: injuries of renal pelvis or ureter 2.99%, residual stones (1.99%), urinary leakage (1.49%), urinary retention (0.995%), arteriovenous fistula (0.497%).

CONCLUSIONS

Percutaneous nephrolithotomy is a highly effective treatment of stones removal from the kidney. It is characterized by a small percentage of serious complications, especially when it is performed by an experienced operator. The modified Clavien-Dindo classification of complications is useful in monitoring and comparing the results obtained for this procedure.