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Postoperative Pulmonary Complications among Patients Undergone Percutaneous Nephrolithotomy


Affiliations
1 Annapoorna Medical College, Salem, Tamil Nadu, India
2 Vinayaka Mission Hi-Tech Hospital Unit of Vinayaka Mission Kirupanathavariyar Medical College, Salem, Tamil Nadu, India
 

Background: Post-operative pulmonary complications (PPC) are not unusual following anesthesia and surgery in PCNL as the incidence is being higher. Complication rates vary according to different procedures and different types of anesthesia and may be affected by the patient condition.

Objective: To assess postoperative pulmonary complications among the patients who had undergone PCNL.

Methodology: This was a prospective observational study of 111 consecutive adult patients over a period of one year who underwent PCNL surgery. The data of the patient, surgery and anesthesia was collected and analyzed to find association with PPC.

Results: Seven patients (6.3%) had developed pulmonary complications postoperatively, six of them had pneumothorax and one had atelectasis who, died at the 15th postoperative day due to respiratory failure. All the 6 patients with pneumothorax were managed by inserting a chest drain. The other non pulmonary complications among the patients were shivering (40%), blood loss (15%), hyperthermia (9%). It is seen that patients who had a history of smoking and the patients who were operated on the left kidney had shown more incidence of developing pneumothorax and the difference was found to be statistically significant (p<.05).

Conclusions: From the present study it can be concluded that the most common type of post-operative complication following PCNL is pulmonary, with pneumothorax. A close working relationship between the surgeon and anesthetist is essential to coordinate the access puncture with deflation of lung and ventilator standstill to minimize the chances of pleural injury.


Keywords

Pulmonary Complications, Nephrolithotomy, Pneumothorax.
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  • Carey RI, FM Siddiq. Conservative management of a splenic injury related to percutaneous nephrostolithotomy. JSLS 2006;10(4):504-506.

  • Goodwin WE, WC Casey. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955; 157(11):891-894.

  • Stables DP. Percutaneous nephrostomy: techniques, indications, and results. Urol Clin North Am 1982;9(1):15-29.

  • Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.

  • Clavien PA, Barkun J, de Oliveira ML. The Clavien- Dindo classification of surgical complications: Five-year experience. Ann Surg 2009;250:187–196.

  • Rozentsveig V, Neulander EZ, Roussabrov E. Anesthetic considerations during percutaneous nephrolithotomy. J Clin Anesth 2007;19:351-5.

  • Mehrabi S, Karimzadeh Shirazi K. Results and complications of spinal anesthesia in percutaneous nephrolithotomy. Urol J 2010;7:22-5.

  • Aravantinos E, Karatzas A, Gravas S, Tzortzis V, Melekos M. Feasibility of percutaneous nephrolithotomy under assisted local anaesthesia: a prospective study on selected patients with upper urinary tract obstruction. Eur Urol 2007;51:224-7.

  • El-Husseiny T, Moraitis K, Maan Z. Percutaneous endourologic procedures in high-risk patients in the lateral decubitus position under regional anesthesia. J Endourol 2009;23:1603-6.

  • Sadrollah Mehrabi, Ali Mousavi Zadeh, Mehdi Akbartabar Toori, Farhad Mehrabi. General Versus Spinal Anesthesia in Percutaneous Nephrolithotomy. Urology journal 2013;10(1):756 – 61.

  • Lawrence VA, Dhanda R, Hilsenbeck SG, Page CP. Risk of pulmonary complications after elective abdominal surgery. Chest 1996;110:744–750.

  • Rock P, Rich PB. Postoperative pulmonary complications. Curr Opin Anaesthesiol 2003;16:123–132.

  • Canet J, Mazo V. Postoperative pulmonary complications. Minerva Anestesiol 2010;76: 138–143.

  • Smetana GW, Lawrence VA, Cornell JE. American College of Physicians: Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med 2006;144:581– 595.

  • Canet J, Gallart L. Predicting postoperative pulmonary complications in the general population. Curr Opin Anaesthesiol 2013;26:107–115.

  • Gupta R, Kumar A, Kapoor R, Srivastava. Prospective evaluation of safety and efficacy of the supracostal approach for percutaneous nephrolithotomy. BJU international 2002;90:809-13.

  • Munver R, Delvecchio FC, Newman GE. Critical analysis of supracostal access for percutaneous renal surgery. J Urol 2001;166:1242-46.

  • Kukreja R, Desai N, Patel S, Bapat S. Factors affecting blood loss during percutaneous nephrolithotomy: Prospective study. J Endourol 2004;18:715-722.

  • C Chang Te Lin, Yeong chin Jou, Ming-Chin Cheng, Cheng Huang Shen, Pi-heng. Delayed hydrothorax after percutaneous nephrolithotomy. JTUA 2009;20(4):190-91.

  • Hahn RG. Fluid absorption in endoscopic surgery. Br J Anaesth 2006;96:8– 20.

  • Netto NR Jr, Ikonomidis J, Ikari O, Claro JA. Comparative study of percutaneous access for staghorn calculi. Urology 2005;65:659– 662.

  • Shilo Y, Kleinmann J, Zisman A, Peer A, Lindner A, Siegel YI. Comparative morbidity for different accesses in percutaneous nephrolithotripsy. Harefuah 2006;145:107– 110.

  • Gili Palnizkya, Sarel Halachmib, Michal Barak. Pulmonary Complications following Percutaneous Nephrolithotomy. Curr Urol 2013;7:113–116.


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  • Postoperative Pulmonary Complications among Patients Undergone Percutaneous Nephrolithotomy

Abstract Views: 268  |  PDF Views: 163

Authors

Joe Annaji
Annapoorna Medical College, Salem, Tamil Nadu, India
R. Brindha
Annapoorna Medical College, Salem, Tamil Nadu, India
S. V. Sowmya
Vinayaka Mission Hi-Tech Hospital Unit of Vinayaka Mission Kirupanathavariyar Medical College, Salem, Tamil Nadu, India

Abstract


Background: Post-operative pulmonary complications (PPC) are not unusual following anesthesia and surgery in PCNL as the incidence is being higher. Complication rates vary according to different procedures and different types of anesthesia and may be affected by the patient condition.

Objective: To assess postoperative pulmonary complications among the patients who had undergone PCNL.

Methodology: This was a prospective observational study of 111 consecutive adult patients over a period of one year who underwent PCNL surgery. The data of the patient, surgery and anesthesia was collected and analyzed to find association with PPC.

Results: Seven patients (6.3%) had developed pulmonary complications postoperatively, six of them had pneumothorax and one had atelectasis who, died at the 15th postoperative day due to respiratory failure. All the 6 patients with pneumothorax were managed by inserting a chest drain. The other non pulmonary complications among the patients were shivering (40%), blood loss (15%), hyperthermia (9%). It is seen that patients who had a history of smoking and the patients who were operated on the left kidney had shown more incidence of developing pneumothorax and the difference was found to be statistically significant (p<.05).

Conclusions: From the present study it can be concluded that the most common type of post-operative complication following PCNL is pulmonary, with pneumothorax. A close working relationship between the surgeon and anesthetist is essential to coordinate the access puncture with deflation of lung and ventilator standstill to minimize the chances of pleural injury.


Keywords


Pulmonary Complications, Nephrolithotomy, Pneumothorax.

References





DOI: https://doi.org/10.18311/ijmds%2F2015%2F79804