Analysis of surgical complications of percutaneous nephrolythotomy, in the first three years, in a teaching hospital

Purpose: To clarify the existing relationships between the characteristics of the patients and calculi and the rate of complications associated with contemporary percutaneous nephrolithotomy (PCNL). Methods: Retrospective cohort study of 126 consecutive patients who underwent PCNL at the academic medical center of the State Hospital of Sumare-University of Campinas from 2016 to 2019. This study examined the correlation of pre-existing comorbidities and calculi characteristics with the incidence of postoperative complications. Results: 72 (57.14%) needed complementary procedure for the residual stone fragments (defined as fragments size >3 mm). Complications occurred in 28 patients (22.22%). Of the patients who did not present any complications (n=98, 77.77%), 61 (62.24%) stayed in the hospital for 1-3 days. The length of hospital stays significantly correlated with higher grade of complication (P=0.018). Grade Ill staghorn calculi demonstrated a greater number of residual stone fragments (P<0.001). In this group of staghorn calculi (n=27, 21.42%), 24 (88.88%) presented with residual stone fragments after the PCNL procedure (P<0.001). Conclusions: PCNL complications are related to longer hospital stay and calculus complexity is directly related to the rate of residual stone fragments, especially in cases of grade III staghorn calculi.