Day care percutaneous nephrolithotomy in COVID era

Abstract

Objective: To assess the success rate of day care percutaneous nephrolithotomy during COVID-19 pandemic.

Methodology: It was an observational study conducted at the urology department of LUMHS Jamshoro, Sindh, Pakistan from January 2021 to April 2022. Patients older than 18 years within 30 km of Jamshoro LUMHS with renal stones who presented for percutaneous nephrolithotomy were included in the study. Pre-operatively data regarding patient’s demographics and stone characteristics were obtained. Non-contrast CT was used to determine stone characteristics like size and site. All patients were undergoing surgery under general anesthesia. Fragmentation of stones was assessed using Holmiun laser or Master lithocast. Flushing, irrigation or grasper were utilized to extract small size stones. Clearance of stone was confirmed by fluoroscopy and endoscopy. Retaining Ureteric catheter or DJ stent was placed after surgery based on the preference of surgeon. After surgery patients were kept under observation for 24 hours to look for complications like bleeding and temperature. All data was recorded on pre-designed proforma.

Results: The mean age of the patients was 26.90±10.83 years. Of 60 patients, 63.3% were males and 36.7% were females. The mean procedure time was 65.48±14.03 minutes (range: 40 to 90 minutes). About 91.7% of the patients had complete stone clearance. While, 3 patients had <10% stone burden remaining and 2 patients had <25% stone burden remaining. All the patients discharged within 24 hours of percutaneous nephrolithotomy without having any complication.

Conclusion: PCNL can be done as day care in selective patients, that reduces the hospital burden of patients and attendant during pandemic Covid – 19.