Day-surgery percutaneous nephrolithotomy: a high-volume center retrospective experience.
PURPOSE
Percutaneous nephrolithotomy (PCNL) is traditionally performed on an inpatient basis. We determine the safety and outcome of day-surgery PCNL by experienced surgeon hands.


PATIENTS AND METHODS
A protocol for day-surgery PCNL was undertaken. A retrospective analysis of all 86 cases of planned day-surgery PCNL accomplished by an experienced surgeon who followed this protocol between May 2017 and March 2019 was performed. Patient demographics, operative data, complications, and readmission rates were recorded. Day-surgery PCNL was defined as discharge of patients either the same day or within 24 h after surgery.


RESULTS
The average stone burden was 361.1 mm2 and 70 (81.4%) of patients had multiple stones or staghorn stones. 82 (95.4%) patients achieved same-day discharge or received overnight observation prior to discharge, and 4 patients (4.6%) required full admission (longer than 24 h). The readmission rate was 2.3% (2 patients). The postoperative complications occurred in 10 (11.6%) patients, including 7, 2, 2 of grade I, II, III complications. The average operation time was 64 min and the hemoglobin drop was 15.7 ± 16.9 g/L. The established tracts size ranged from 16 to 22Fr. The stone clearance rate was 90.7%. The tubeless without nephrostomy tube was performed in 60.5%. Eight cases were performed by multiple-tracts PCNL with 2-4 tracts, with only two case required full admission.


CONCLUSION
Experienced surgeons who performed day-surgery PCNL experience excellent patient outcomes in appropriately selected patients. Most complications can be treated conservatively and only a few required intervention or readmission.
['Wu|Xiangkun|X|', 'Zhao|Zhijian|Z|', 'Sun|Hongling|H|', 'Cai|Chao|C|', 'Li|Zhilin|Z|', 'Cheng|Donglong|D|', 'Zhu|Huacai|H|', 'Zeng|Guohua|G|', 'Liu|Yongda|Y|']
D000328:Adult D000556:Ambulatory Surgical Procedures D005260:Female D061847:Hospitals, High-Volume D006801:Humans D007669:Kidney Calculi D008297:Male D008875:Middle Aged D000074642:Nephrolithotomy, Percutaneous D012189:Retrospective Studies D016896:Treatment Outcome
Percutaneous nephrolithotomy Outcomes Day-surgery PCNL Staghorn stone Multiple tracts