Radiology, Vol 157, 51-55, Copyright © 1985 by Radiological Society of North America
Complications of percutaneous nephrostolithotomy
NR Dunnick, CC Carson, SD Braun, GA Miller, R Cohan, GE Degesys, FF Illescas, GE Newman and JL Weinerth
In 224 patients, renal stones were removed from the urinary tract using
either direct extraction with a basket or forceps (59 patients), ultrasonic
lithotripsy (164 patients), or infusion chemotherapy (one patient).
Residual stone fragments were present more frequently in patients treated
with ultrasonic lithotripsy (27%) than with direct extraction (5%). Other
complications included hemorrhage (eight patients), catheter dislodgement
(four patients), large amounts of urine extravasation (three patients),
glycine ascites (three patients), infection (two patients), pneumothorax
(one patient), and a prolonged ileus (one patient). More complications
occurred among the first 50 patients than the last 50 patients, even though
more difficult cases, including patients with staghorn calculi, were
accepted during the latter period. Although a learning curve exists,
complications can be minimized by attempting to treat more favorable cases
during the initial experience.
