Percutaneous Nephrestom Post-operative nephrolithotomy renal function improvement in obstructed renal calculus disease between pre-operatively percutaneous nephrostomy diverted and non-diverted patients

Abstract

          The majority If urinary stone patients in Lumphun hospital was renal calculus, resulting in complicated urinary tract infection, renal insufficiency, progressive renal impairment and death if left untreated. There are definite and several surgical treatment including palliative surgical interventions. Percutaneous nephrostomy (PCN) was minimally invasive palliative urinary diversion, not only relief urinary obstruction, but also prevent further renal damage caused by renal stone. Objective: To compare post-operative renal function improvement in previously percutaneous nephrostomised renal calculus patients, to that of non-diverted (nonPCN) patients. Retrospective cohort study Place: male urologic, female surgical department, Lamphun hospital. Method: Renal functions were examined by serumcreatinine at one day before surgical, third, seventh day was second week after nephrolithotomy was performed 35 patients were included 27 patients of PCN group and 18 patients of non PCN group Result: Male: Female ratio was 68.57.31.43, 60% was mild-hydronephrotic, and 40% was severe hydronephrotic patients. The percentage of normal serumcreatinine patients before operation performed in PCN group was 58.82%, at third post-operative day was 47.06%, 64.71% at first week and 70.59% at second week after surgery. The percentage of normal serumcreatinine patients before Nephrolithotomy in non-PCN group was 72.22%, at third post operative day was 72.22%, 66.67% at first week and 72.22% at second week after surgery. Prolonged length of hospital stay than 2 weeks of 73.68% was observed in PCN group and 26.32% in non PCN group. Post-operative complication 71.43% was observed in PCN group and 28.58% in non PCN group. Conclusions: Post-operative renal function improvement in renal calculus patients previously urinary diverted by PCN was higher than non-previously diverted patients