Percutaneous nephrolithotomy ambulatory: Case series and literature review

Abstract

Objective Our goal is to present our experience with 20 patients with renal calculi who underwent ambulatory percutaneous nephrolithotomy, based on strict preoperative and intraoperative criteria; Strengthening the advantages of our technique such as early discharge, low requirements of postoperative analgesics, high rate of free calculations and a low frequency of complications. Methods We performed an investigation in the literature in the search bases. Through the application of preoperative, intraoperative and postoperative criteria, we selected 20 patients to be submitted to percutaneous nephrolithotomy between November 2015 and May 2016. Results Regarding the intraoperative characteristics, the surgical time can be emphasized, which was 70 minutes and there were no significant bleeding that required transfusions. There were no intraoperative complications. The discharge was during the first 8 hours postoperatively. Pain follow-up was performed; evidencing at 24 hours that 100% of patients presented pain ¼/ < 4/10. The control was performed with uroTAC observing a free rate of stones less than 2 mm of 90% and less than 4 mm in 95%. Among the complications presented were 2 readmissions that were managed ambulatorily without complications. Conclusions Ambulatory NLP is a safe treatment option, with an excellent success rate. Preoperative tools such as nomograms allow the evaluation of the characteristics of the stone, with the porpouse to offer better success rates, procedures with lower complication rates and insurance.