Complications of percutaneous nephrolithotomy (PNL) classified by the modified clavien grading system at the urology department Kaser-El-Aini hospital Cairo University / Mutei Abdulla Ali Alshaer ; Supervised Khaled Mursi Hammoud , Ashraf Mohamed Emran , Mohamed Galal Elsheikh

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Urology

This prospective study aimed to classify the complications of the percutaneous nephrolithotomy (PNL) by the modified clavien grading system at the urology department Kasr-El-Aini hospital, Cairo University in terms of efficacy, safety, operative procedure, intraoperative and early postoperative complications. Procedures were performed on 77 adult patients during the period from February 2013 to August 2014. Perioperative assessment and investigations were done. The most common grade I complication was fever,occurring in 20 of our patients (26.0%). Fever, defined as at least a single Episode spiking more then 38{u00B0}C. Grade II complications occurred in 15 (19.4%) of our patients, and the most were bleeding necessitating blood transfusion occurred in 9 (11.6%) patients, followed by peri-nephrostomy catheter urine leakage, which was detected in 6 (7.8%) patients. The difference between pre and post-operative hemoglobin level was used as an indicator of blood loss, in our study blood transfusion was required in 9 patients (11.6%) and the mean decrease in hemoglobin level was 2.73 g/dl. In our study we are grading auxillary treatment, such as SWL and re-PNL as grade III complication. Atotal of 15 (19.5%) of our patients underwent auxillary treatment. Because re-PNL required general anesthesia, classified as grade IIIb, which was essential in 7 (9.1%) patient. SWL may be consider as grade IIIa complication, because it is generally not done under general anesthesia, and it was needed in 8 (10.4%) patients. Double.J stent placement for renal pelvis injury was applied in 3 (3.9%) patients, it was regarded as grade IIIa complication.Major or significant complications were generally uncommon, frequency of urosepsis/septicemia occurred in 1(1.3%) of our patients, it was regarding as grade IVb complication.The mean operative time in our study was 116.36 minutes (median 2 hours ) S.D 47.67 minutes. . The mean hospital stay was 3.3 ± 0.61 days. The stone free rate at the first session was (80.5 %) and increased to 89.0% after second look PNL

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