Document Detail

Perioperative complications and risk factors of percutaneous nephrolithotomy.
MedLine Citation:
PMID:  16850684     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the risk factors of perioperative complications of PerCutaneous NephroLithotomy (PCNL). MATERIAL AND METHOD: The present prospective descriptive study was carried out in the first time operation of 128 PCNL patients after general balanced anesthesia and standard surgical technique. Irrigation fluids were 0.9% NSS (24.1 +/- 16.36 liters) at room temperature. Perioperative complications and risk factors were observed, the results were displayed as adjusted Odds Ratio (OR), 95%CI and p value. RESULTS: Intraoperative complications were hypothermia (56.2%), cardiovascular changes (57.1%) and bleeding. The first two complications statistically significantly related to volume of irrigation fluid > 20 liters (7.4, p < 0.05). Postoperative complications were electrolyte changes (but not statistically significant), pleural tear (3 cases), infection and bleeding. Septic shock was found in 4.7% (6/128) and 0.78% (1/128) died. Fever was significantly correlated with postoperative transfusion > or = 1 unit (adjusted OR 4.9, p < 0.05). Risk factors of postoperative bleeding were operation time (adjusted OR 4.4, p < 0.05), intraoperative transfusion (adjusted OR 10, p < 0.01) and postoperative fever (adjusted OR 4.9 p < 0.01). Mean was 7.3 +/- 5.22 days and the mode of Length Of Stay after operation (LOS(PO)) was 5 days. LOS(PO) was significantly related with postoperative fever > 38.5 degrees C (adjusted OR 2.7, p < 0.05). CONCLUSION: Volume of irrigation fluid at room temperature >20 liters significantly increased the rate of intraoperative hypothermia and cardiovascular changes. Infection was the most serious complication of PCNL and increased LOS(PO). Antibiotics started at the beginning of the surgery could not always prevent this event.
Puttipannee Vorrakitpokatorn; Krisana Permtongchuchai; Em-Orn Raksamani; Anchana Phettongkam
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  89     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-20     Completed Date:  2006-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  826-33     Citation Subset:  IM    
Department of Anesthesiology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Length of Stay
Middle Aged
Nephrostomy, Percutaneous / adverse effects*
Postoperative Complications / prevention & control
Preoperative Care*
Prospective Studies
Risk Assessment
Risk Factors
Treatment Outcome*

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