Mp78-15 Comparative Outcomes in Patients With Pre-Existing Nephrostomy Tube Prior to Percutaneous Nephrolithotomy (Pcnl): Retrospective Analysis of Tract Reutilization vs New Intraoperative Access

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) V (MP78)1 May 2024MP78-15 COMPARATIVE OUTCOMES IN PATIENTS WITH PRE-EXISTING NEPHROSTOMY TUBE PRIOR TO PERCUTANEOUS NEPHROLITHOTOMY (PCNL): RETROSPECTIVE ANALYSIS OF TRACT REUTILIZATION VS NEW INTRAOPERATIVE ACCESS Kameron Bell, Max Shelton, Nicholas Crowe, William Stanton, David Dalton, Austen Slade, R. J. Caras, and Marcelino Rivera Kameron BellKameron Bell , Max SheltonMax Shelton , Nicholas CroweNicholas Crowe , William StantonWilliam Stanton , David DaltonDavid Dalton , Austen SladeAusten Slade , R. J. CarasR. J. Caras , and Marcelino RiveraMarcelino Rivera View All Author Informationhttps://doi.org/10.1097/01.JU.0001008856.05210.73.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous nephrolithotomy (PCNL) is indicated for the treatment of large renal calculi. At our institution, percutaneous access into the kidney is performed by urologists the majority of the time, however, in some instances, patients already have a percutaneous nephrostomy (PCN) tube placed by interventional radiology (IR) prior to the PCNL surgery. This study aimed to evaluate outcomes of PCNLs in patients with pre-existing nephrostomy tubes and focused on pre-existing PCN tract utilization versus new urology-obtained intraoperative access. METHODS: A retrospective study was performed to identify patient who underwent unilateral PCNL with preoperative nephrostomy tube placement by interventional radiology at a single institution from 2017 to 2022. Patient demographic data, surgical outcomes and 30-day postoperative data was analyzed. RESULTS: A total of 79 patients met inclusion criteria. In 63 patients (79.7%), the existing nephrostomy access was used to perform PCNL, while in 16 (20.3%) patients new intraoperative access was obtained. No differences were noted in postoperative stent or nephrostomy tube placement, residual stone burden, same-day discharge rate, or ipsilateral secondary surgery at 90 days. 30-day complication rates and emergency department visits were higher in the PCN tract set at 29 (46.03%) vs 1 (6.25%). CONCLUSIONS: Our findings reveal a statistically significant increase in the 30-day complication rate when the PCN tract was reused compared to when new intraoperative access was obtained (46% vs. 6.3%, respectively). This observation suggests a potential advantage in establishing new intraoperative access during PCNL in patients with a pre-existing nephrostomy tubes. Further studies are warranted to substantiate these results and to identify the underlying factors responsible for the increased complication rate. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1269 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kameron Bell More articles by this author Max Shelton More articles by this author Nicholas Crowe More articles by this author William Stanton More articles by this author David Dalton More articles by this author Austen Slade More articles by this author R. J. Caras More articles by this author Marcelino Rivera More articles by this author Expand All Advertisement PDF downloadLoading ...