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Can percutaneous nephrolithotomy be performed as an outpatient procedure?

OBJECTIVES: To examine the safety and effectiveness of percutaneous nephrolithotomy (PCNL) as an outpatient procedure, as in most centres PCNL is performed as an inpatient procedure that necessitates postoperative hospital admission. PATIENTS AND METHODS: Our study included 186 patients undergoing P...

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Detalles Bibliográficos
Autores principales: Fahmy, Ahmed, Rhashad, Hazem, Algebaly, Omer, Sameh, Wael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329725/
https://www.ncbi.nlm.nih.gov/pubmed/28275511
http://dx.doi.org/10.1016/j.aju.2016.11.006
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author Fahmy, Ahmed
Rhashad, Hazem
Algebaly, Omer
Sameh, Wael
author_facet Fahmy, Ahmed
Rhashad, Hazem
Algebaly, Omer
Sameh, Wael
author_sort Fahmy, Ahmed
collection PubMed
description OBJECTIVES: To examine the safety and effectiveness of percutaneous nephrolithotomy (PCNL) as an outpatient procedure, as in most centres PCNL is performed as an inpatient procedure that necessitates postoperative hospital admission. PATIENTS AND METHODS: Our study included 186 patients undergoing PCNL for renal calculi. Only those who met strict inclusion criteria were discharged home on the same day. Preoperative eligibility criteria for outpatient management included no complex medical problem, normal renal function, and easy access to an emergency room. Patients were divided into two groups. The outpatient group (Group 1) included those patients discharged on the same day as the PCNL and the hospitalised group (Group 2) included those who were considered appropriate for outpatient management but needed to be hospitalised. RESULTS: In all, 162 patients (87%) fulfilled the inclusion criteria for outpatient management and 146 of these patients (90.1%) planned for outpatient management were discharged on the same operative day (Group 1). The mean time to discharge home was 8.97 h. In all, 16 patients who opted for the outpatient approach subsequently required hospitalisation (Group 2). In the hospitalised group the mean operative time was longer, which was probably related to its higher stone burden. CONCLUSION: PCNL can be safely performed with excellent outcomes as an outpatient procedure. Outpatient PCNL offers several advantages including a more rapid patient convalescence, reduced healthcare expenditure, decreased postoperative nosocomial infections with no additional morbidity for the patient, and with no compromising of the stone-free rate.
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spelling pubmed-53297252017-03-08 Can percutaneous nephrolithotomy be performed as an outpatient procedure? Fahmy, Ahmed Rhashad, Hazem Algebaly, Omer Sameh, Wael Arab J Urol Original Article OBJECTIVES: To examine the safety and effectiveness of percutaneous nephrolithotomy (PCNL) as an outpatient procedure, as in most centres PCNL is performed as an inpatient procedure that necessitates postoperative hospital admission. PATIENTS AND METHODS: Our study included 186 patients undergoing PCNL for renal calculi. Only those who met strict inclusion criteria were discharged home on the same day. Preoperative eligibility criteria for outpatient management included no complex medical problem, normal renal function, and easy access to an emergency room. Patients were divided into two groups. The outpatient group (Group 1) included those patients discharged on the same day as the PCNL and the hospitalised group (Group 2) included those who were considered appropriate for outpatient management but needed to be hospitalised. RESULTS: In all, 162 patients (87%) fulfilled the inclusion criteria for outpatient management and 146 of these patients (90.1%) planned for outpatient management were discharged on the same operative day (Group 1). The mean time to discharge home was 8.97 h. In all, 16 patients who opted for the outpatient approach subsequently required hospitalisation (Group 2). In the hospitalised group the mean operative time was longer, which was probably related to its higher stone burden. CONCLUSION: PCNL can be safely performed with excellent outcomes as an outpatient procedure. Outpatient PCNL offers several advantages including a more rapid patient convalescence, reduced healthcare expenditure, decreased postoperative nosocomial infections with no additional morbidity for the patient, and with no compromising of the stone-free rate. Elsevier 2017-01-20 /pmc/articles/PMC5329725/ /pubmed/28275511 http://dx.doi.org/10.1016/j.aju.2016.11.006 Text en © 2017 Arab Association of Urology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Fahmy, Ahmed
Rhashad, Hazem
Algebaly, Omer
Sameh, Wael
Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title_full Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title_fullStr Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title_full_unstemmed Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title_short Can percutaneous nephrolithotomy be performed as an outpatient procedure?
title_sort can percutaneous nephrolithotomy be performed as an outpatient procedure?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329725/
https://www.ncbi.nlm.nih.gov/pubmed/28275511
http://dx.doi.org/10.1016/j.aju.2016.11.006
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