Русский
Complications after PCNL: diagnosis and management
DOI: https://dx.doi.org/10.18565/urology.2020.5.139-148
N.K. Gadzhiev, V.M. Obidnyak, D.S. Gorelov, V.A. Malkhasyan, G.N. Akopyan, D.A. Mazurenko, R.R. Kharchilava, S.B. Petrov, A.G. Martov
1Department of Urology No2 (extracorporeal shock-wave lithotripsy and endovideosurgery) of Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation, Saint Petersburg, Russia; 2Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; 3I.M. Sechenov First Moscow State Medical University of Ministry of Health of Russia, Moscow, Russia; 4Department of Urology and Andrology of A.I. Burnazyan SRC FMBC, FMBA of Russia; 5“Praxi Medica” Medical Practice Training Center, I.M. Sechenov First Moscow State Medical University of Ministry of Health of Russia, Moscow, Russia; 6Urologic Clinic of Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation, Saint Petersburg, Russia; 7Urologic department №2 of GBUZ “City clinical hospital named after D.D. Pletnev of the Health Department c. Moscow”; 8Department of Urology and Andrology, Medical Research Center, Moscow, Russia
Percutaneous nephrolithotomy (PCNL) is the gold standard treatment of large and staghorn kidney stones. Despite technological progress and improvement of PCNL technique, this procedure is associated with complications and in some cases remain a challenge for endourologists.
According to the time, complications can be divided into intra- and postoperative. Intraoperative complications include bleeding, injury of the renal collecting system, visceral organs, pulmonary complications, thromboembolic disorders, extrarenal migration of the stone fragments and incorrect nephrostomy tube placement. Postoperative complications include infection and sepsis, bleeding, persistent urinary fistula, infundibular stenosis and death of the patient. The different recommendations that might be useful for the timely diagnosis of various complications in patients undergoing PCNL are provided in the review. Additionally, information on treatment algorithms is included.
According to the time, complications can be divided into intra- and postoperative. Intraoperative complications include bleeding, injury of the renal collecting system, visceral organs, pulmonary complications, thromboembolic disorders, extrarenal migration of the stone fragments and incorrect nephrostomy tube placement. Postoperative complications include infection and sepsis, bleeding, persistent urinary fistula, infundibular stenosis and death of the patient. The different recommendations that might be useful for the timely diagnosis of various complications in patients undergoing PCNL are provided in the review. Additionally, information on treatment algorithms is included.
Keywords: percutaneous nephrolithotripsy, complications, urolithiasis
About the Autors
Corresponding author: N.K. Gadjiev – urologist, Ph.D., MD, Head of the Department of Urology No2 (extracorporeal shock-wave lithotripsy and endovideosurgery) of Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation, Saint Petersburg, Russia; e-mail: nariman.gadjiev@gmail.com
