CU 42. The diverstity of complications of PCNL and related factors

Objective: To investigate the diversity of the complications after PCNL and identify the influence factors by analyzing the complications after the PCNL in prospective global survey database of CROES (Clinical Research Office of the Endourological Society) Clinical data: 96 urological centers of 26 countries participated in the study, every center collected all cases of kidney stones treated by PCNL for 1 year, recorded the postoperative complications and scored them using Clavien Scoring Method according to the severity.

Results: Totally, 5803 continuous cases were collected and 5724 cases got a integrated Clavien Scoring Method among them, in addition, more than one consequent complication arised in 1175 cases (20.5%). It is counted that 82 postoperative complications in total appeared. Including eight common complications and every kind of complication also had more than 20 cases supported, including pyrexia hemorrhages, urinary fistula, pleural effusion, hematuria, Urinary Tract Inflammation, Renal pelvis penetration, Urinary Leak. Nevertheless, Rare complications came up with eight types and every type ranking in 10-20 cases, including hematoma, postoperative pain, ureter obstruction, Fistula prolapse, pneumothorax, pleural effusion, fistula obstruction. Still, Other 66 complications showed up, including bacteremia, Injury of Colon, hypotension, anemia, aneurysma spurium, Arteriovenous fistula, etc. A total of 2 death cases appeared in this study. Related factors of complication severity included American Society of Anesthesiologists (ASA) physical status classication, use of the anticoagulant drugs, the positive Urine culture, and combined cardiovascular disease, in which, the Postoperative Clavien was affected mostly by ASA physical status classication. Multivariate analysis certificated that ASA Score and operating time can predict the severity of postoperative complications.

Conclusions: PCNL complications varied, but most are not serious. The longer operation time and higher ASA score prompted greater risk of serious postoperative complications.