Comparison of Percutaneous Nephrolithotomy Operations Under Spinal Versus General Anesthesia

Ugur Yucetas; Hüseyin Aytaç Ateş; Ali Ferruh Akay; Emre Karabay; Mustafa Kadıhasanoglu; Erkan Erkan

Makale detayları

Comparison of Percutaneous Nephrolithotomy Operations Under Spinal Versus General Anesthesia

Yazarlar:

Ugur Yucetas | Hüseyin Aytaç Ateş | Ali Ferruh Akay | Emre Karabay | Mustafa Kadıhasanoglu | Erkan Erkan

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Üroloji

Dergi:

Osmangazi Tıp Dergisi Vol.46 Issue 4, pp.545-550

Belge Tipi:

Makale

Yayın Tarihi:

7/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001314138

pISSN:

1305-4953

Anahtar kelimeler:

Özet:

 This study evaluates the impact of spinal versus general anesthesia on outcomes in percutaneous nephrolithotomy PNL. We analyzed 200 patients 100 spinal, 100 general who underwent PNL in our clinic from 2012 to 2017. The median age was 45.0022.00 years, and the median stone size was 568.50673.75 mm². PNL was performed on the right kidney in 90 patients and the left kidney in 110 patients, with a single subcostal entry in 97.5 of cases. The median operation time was 45.0035.00 minutes, the median hospital stay was 4.002.00 days, and the median nephrostomy catheter duration was 3.003.00 days. A 73 stone-free rate was achieved after PNL operations performed in the prone position under fluoroscopy guidance. While 82 of the cases had no complications, 9 experienced high fever, 5.5 required blood transfusion due to bleeding, and 3.5 developed prolonged drainage requiring double J catheterization.In comparing the spinal and general anesthesia groups, there were no differences in gender, side, entry location, or stone size. However, significant differences were found in age p0.0153, stone location p0.0001, operation time p0.0001, hospital stay p0.0001, nephrostomy catheter duration p0.0001, stone-free rate p0.0021, and complication rates p0.0155. Despite the common use of general anesthesia in PNL, our findings indicate that spinal anesthesia may yield higher stone-free rates and fewer complications, irrespective of stone size. Therefore, PNL under spinal anesthesia can be safely and effectively performed, particularly in patients at high risk for general anesthesia. Further high-volume and prospective studies are warranted.

 This study evaluates the impact of spinal versus general anesthesia on outcomes in percutaneous nephrolithotomy PNL. We analyzed 200 patients 100 spinal, 100 general who underwent PNL in our clinic from 2012 to 2017. The median age was 45.0022.00 years, and the median stone size was 568.50673.75 mm². PNL was performed on the right kidney in 90 patients and the left kidney in 110 patients, with a single subcostal entry in 97.5 of cases. The median operation time was 45.0035.00 minutes, the median hospital stay was 4.002.00 days, and the median nephrostomy catheter duration was 3.003.00 days. A 73 stone-free rate was achieved after PNL operations performed in the prone position under fluoroscopy guidance. While 82 of the cases had no complications, 9 experienced high fever, 5.5 required blood transfusion due to bleeding, and 3.5 developed prolonged drainage requiring double J catheterization.In comparing the spinal and general anesthesia groups, there were no differences in gender, side, entry location, or stone size. However, significant differences were found in age p0.0153, stone location p0.0001, operation time p0.0001, hospital stay p0.0001, nephrostomy catheter duration p0.0001, stone-free rate p0.0021, and complication rates p0.0155. Despite the common use of general anesthesia in PNL, our findings indicate that spinal anesthesia may yield higher stone-free rates and fewer complications, irrespective of stone size. Therefore, PNL under spinal anesthesia can be safely and effectively performed, particularly in patients at high risk for general anesthesia. Further high-volume and prospective studies are warranted.

 This study evaluates the impact of spinal versus general anesthesia on outcomes in percutaneous nephrolithotomy PNL. We analyzed 200 patients 100 spinal, 100 general who underwent PNL in our clinic from 2012 to 2017. The median age was 45.0022.00 years, and the median stone size was 568.50673.75 mm². PNL was performed on the right kidney in 90 patients and the left kidney in 110 patients, with a single subcostal entry in 97.5 of cases. The median operation time was 45.0035.00 minutes, the median hospital stay was 4.002.00 days, and the median nephrostomy catheter duration was 3.003.00 days. A 73 stone-free rate was achieved after PNL operations performed in the prone position under fluoroscopy guidance. While 82 of the cases had no complications, 9 experienced high fever, 5.5 required blood transfusion due to bleeding, and 3.5 developed prolonged drainage requiring double J catheterization.In comparing the spinal and general anesthesia groups, there were no differences in gender, side, entry location, or stone size. However, significant differences were found in age p0.0153, stone location p0.0001, operation time p0.0001, hospital stay p0.0001, nephrostomy catheter duration p0.0001, stone-free rate p0.0021, and complication rates p0.0155. Despite the common use of general anesthesia in PNL, our findings indicate that spinal anesthesia may yield higher stone-free rates and fewer complications, irrespective of stone size. Therefore, PNL under spinal anesthesia can be safely and effectively performed, particularly in patients at high risk for general anesthesia. Further high-volume and prospective studies are warranted.

 Bu çalışma, perkütan nefrolitotomide PNL spinal ve genel anestezinin sonuçlar üzerindeki etkilerini karşılaştırmayı amaçlamaktadır. Kliniğimizde 2012-2017 yılları arasında gerçekleştirilen Perkütan nefrolitotomi gerçekleştirilen 200 hastanın 100 spinal,100 genel ortanca yaşı 45,0022,00 ve ortanca taş boyutu 568,50673,75 mm2 idi. PNL, 90 hastada sağ böbreğe, 110 hastada sol böbreğe uygulandı. Olguların 97,5inde tek ve subkostal giriş gerçekleştirildi. Ortanca operasyon süresi 45,0035,00 dakika, ortanca hastanede kalış süresi 4,002,00 gün ve ortanca nefrostomi kateter süresi 3,003,00 gün olarak saptandı. Hastaların tamamında pron pozisyonunda ve floroskopi eşliğinde gerçekleştirilen PNL operasyonları sonrası 73 taşsızlık sağlandı. Olguların 82sinde herhangi bir sorun gözlenmezken; 9unda operasyon sonrası yüksek ateş, 5,5inde transfüzyon gerektiren kanama ve 3,5inde double j kateterizasyon gerektiren uzamış drenaj gelişti. Spinal ve genel anestezi ile opere edilen olgulara ait bulgular karşılaştırıldığında; cinsiyet, taraf, giriş lokalizasyonu ve taş boyutu açısından farklılık saptanmazken, yaş p0,0153, taş lokalizasyonu p0,0001, operasyon süresi p0,0001, hastanede yatış süresi p0,0001, nefrostomi kateter süresi p0,0001, taşsızlık oranı p0,0021 ve komplikasyon oranları p0,0155 açısından istatistiksel anlamlı farklılık olduğu saptandı. Perkütan nefrolitotomide sıklıkla genel anestezi uygulanmakla beraber, çalışmamızda elde ettiğimiz bulgular spinal anestezinin taş boyutundan bağımsız olarak daha yüksek taşsızlık oranları ve daha az komplikasyon ile uygulanabileceğini göstermektedir. Spinal anestezi ile PNL, özellikle genel anestezi açısından yüksek riskli hastalarda güvenle ve başarı ile uygulanabilir. Bu konuda yüksek volümlü ve prospektif çalışmalara gereksinim vardır.

Makale detayları

Comparison of Percutaneous Nephrolithotomy Operations Under Spinal Versus General Anesthesia

Yazarlar:

Ugur Yucetas | Hüseyin Aytaç Ateş | Ali Ferruh Akay | Emre Karabay | Mustafa Kadıhasanoglu | Erkan Erkan

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Üroloji

Dergi:

Osmangazi Tıp Dergisi Vol.46 Issue 4, pp.545-550

Belge Tipi:

Makale

Yayın Tarihi:

7/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001314138

pISSN:

1305-4953

anesthesia

peructaneous nephrolithotomy

spinalanestezi

perkütan nefrolitotomi

spinal

Sayı

Makale detayları

Comparison of Percutaneous Nephrolithotomy Operations Under Spinal Versus General Anesthesia

Yazarlar: Ugur Yucetas | Hüseyin Aytaç Ateş | Ali Ferruh Akay | Emre Karabay | Mustafa Kadıhasanoglu | Erkan Erkan

Yayıncı: Eskişehir Osmangazi University

Ana Başlıklar: Üroloji

Dergi: Osmangazi Tıp Dergisi Vol.46 Issue 4, pp.545-550

Belge Tipi: Makale

Yayın Tarihi: 7/2024

Belge Dili: Türkçe

Document ID (Org No.): 2001314138

pISSN: 1305-4953

anesthesia

peructaneous nephrolithotomy

spinalanestezi

perkütan nefrolitotomi

spinal

Sayı

Yazarlar:

Ugur Yucetas | Hüseyin Aytaç Ateş | Ali Ferruh Akay | Emre Karabay | Mustafa Kadıhasanoglu | Erkan Erkan

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Üroloji

Dergi:

Osmangazi Tıp Dergisi Vol.46 Issue 4, pp.545-550

Belge Tipi:

Makale

Yayın Tarihi:

7/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001314138

pISSN:

1305-4953