Evaluation of Thoracic Complications After Urological Operations: A Single-center Experience

Objective: To present cases of thoracic complications that developed after urologic interventions and were treated in collaboration with thoracic surgery. Materials and Methods: Patients who were operated in the urology clinic at our hospital between January 2014 and December 2017 and required thoracic surgery consultation were retrospectively reviewed. Forty-two patients with pneumothorax, pleural effusion, hydropneumothorax and diaphragm injury were included in the study. Six patients, who had preoperative diaphragm invasion and underwent preoperative diaphragm incision, were excluded. Results: Tube thoracostomy (TT) was applied in only 5 patients who developed pneumothorax. Three patients with isolated pleural effusion were treated with TT and 3 with thoracentesis. All patients who developed hydropneumothorax were found to have undergone nephrectomy (3 left, 1 right). All patients with iatrogenic diaphragmatic injury were diagnosed perioperatively and all of these patients were nephrectomized (5 right, 1 left). All the patients underwent primary diaphragm repair and 5 patients underwent TT. The mean duration of tube drainage was 5.5 +/- 2.1 (2-13) days. The mean length of hospital stay in patients who underwent percutaneous nephrolithotomy, nephroureterectomy, nephrectomy and prostatectomy with thoracic complications was 4.12 +/- 1.08, 8.26 +/- 2.87, 4.04 +/- 1.23 and 4.17 +/- 0.72 days, respectively. There was no significant difference in mean duration of hospital stay between patients with and without thoracic complications (p=0.729). Conclusion: Thoracic complications may develop after urological interventions. In particular, evaluation of chest pain in patients with right-sided percutaneous nephrolithotomy and nephrectomy by chest X-ray is important for early diagnosis.