Is multiple tracts percutaneous nephrolithotomy (PCNL) safe modality in management of complex renal stones? A prospective study: Single center experience

Abstract

Objectives: To evaluate and analyze the efficacy and the safety of multiple tracts PCNL in management of complex renal calculi. Patients and Methods: The study was conducted during the period between March 2016 till January 2017 on 265 patients with complex renal stones, all patients underwent multiple tracts PCNL, either with double or triple punctures, preoperative and postoperative laboratory and radiological results were compared together in correlation to the stone size, shape and site. Results: The results of our study have shown that increased size and complexity of stones is associated with increased number of punctures needed to achieve stone clearance, and the aggressive approach to complex renal calculi using multiple tracts PCNL is a safe and effective modality in management of complex renal calculi with acceptable complications. Conclusion: Number of percutaneous tracts needed for stone clearance was increased with the increase in stone size and complexity. Surgeon experience, accurate choosing puncture site and carefully performed multiple tracts will decrease the intra-operative and postoperative complications or transfusion requirements. Keywords: Renal stones, Complex, PCNL, Multiple tracts