Ali Mazhar, Naeem Qazi, Zafar Umair, Abbas Ansar, Muhammad Faizan, Naqash Muhammad, Ghouri Nida, Khan Murad A, Ali Abdullah
Urology, Recep Tayyip Erdoğan Hospital, Muzaffargarh, Muzaffargarh, PAK.
Research, Indus Hospital and Health Network, Karachi, PAK.
Cureus. 2024 Sep 17;16(9):e69567. doi: 10.7759/cureus.69567. eCollection 2024 Sep.
Urolithiasis is extremely prevalent in Pakistan, with percutaneous nephrolithotomy (PCNL) emerging as the primary treatment modality over traditional open surgery. Despite its effectiveness, PCNL is associated with a risk of complications and residual stones. There is limited data on PCNL outcomes from Southern Punjab, necessitating an evaluation of its efficacy and safety in this region.
We conducted a retrospective analysis of 399 patients who underwent PCNL at a tertiary care hospital in Muzaffargarh, Pakistan, between October 2016 and September 2022. Detailed preoperative assessments, surgical procedures, and postoperative outcomes were reviewed. Stone clearance and complication rates were assessed, and factors influencing these outcomes were analyzed.
The median age of the study population was 39 years, with a male predominance. Stone clearance was achieved in 80.45% (321) of cases, with higher success rates observed in lower pole punctures. Complications occurred in 2% (13) of patients, predominantly hydrothorax following upper pole puncture. Patients with comorbidities had a higher risk of complications (P = 0.097). Residual stones were more common in staghorn stones and larger stone sizes (>3-4 cm). The median operative time was 60 minutes, shorter than reported in the literature, reflecting surgical expertise.
PCNL is an effective and safe treatment option for urolithiasis in Southern Punjab, Pakistan, with favorable stone clearance rates and low complication rates. Tailoring treatment strategies based on patient characteristics and optimizing surgical techniques are essential for improving outcomes in this population.
尿石症在巴基斯坦极为普遍，经皮肾镜取石术（PCNL）已成为优于传统开放手术的主要治疗方式。尽管PCNL有效，但它与并发症和残留结石的风险相关。来自旁遮普省南部的PCNL治疗结果数据有限，因此有必要评估其在该地区的疗效和安全性。
我们对2016年10月至2022年9月期间在巴基斯坦木扎法尔格尔一家三级护理医院接受PCNL的399例患者进行了回顾性分析。回顾了详细的术前评估、手术过程和术后结果。评估结石清除率和并发症发生率，并分析影响这些结果的因素。
研究人群的中位年龄为39岁，男性居多。80.45%（321例）的病例实现了结石清除，下极穿刺的成功率更高。2%（13例）的患者出现并发症，主要是上极穿刺后发生胸腔积液。合并症患者的并发症风险更高（P = 0.097）。残留结石在鹿角形结石和较大结石尺寸（>3 - 4厘米）中更为常见。中位手术时间为60分钟，比文献报道的短，这反映了手术专业水平。
PCNL是巴基斯坦旁遮普省南部尿石症的一种有效且安全的治疗选择，结石清除率良好，并发症发生率低。根据患者特征调整治疗策略并优化手术技术对于改善该人群的治疗结果至关重要。
