Open Nephrolithotomy in Lamphun hospital

Abstract

This study objective is to evaluate the outcome of open nephrolithotomy, stone free rate, complications and factors associated with stone free patient treated by open nephrolithotomy. 

Method: The retrospective analytic research was conducted in renal calculi patients who had open nephrolithotomy during 2011-2019 in Lamphun hospital. Data were retrieved from medical records and operative notes in all open nephrolithotomy patients. Data were analysed by descriptive and inferential statistical analysis presented as mean, standard deviation, median, iqr, min, max, Odds ratio and 95% confidence interval.   

Result: Total 105 open nephrolithotomy patients were included into the study. The mean age was 54.04 years (SD 9.67), 93 (88.57%) had diagnosed with partial or complete staghorn calculi, median Guy’s stone score and calculus size were 4 (iqr 1) and 6.5 cm. (iqr2.5), 39 cases (37.14%) had serum creatinine ≥ 1.5 mg/dL and 66 cases (62.86%) had serum creatinine less than 1.5 mg/dL, mean intraoperative ischemia time was 43.50 minutes (SD 13.14), median operative time and blood loss were 78 minutes (iqr 35) and 150 cc (iqr 100) respectively. Postoperative complications were recorded in 13 cases (12.28%) and 2 cases needed to reoperation. Stone free rate was 39.05% (41 cases). Factor associated with stone free was serum creatinine ≥ 1.5 mg/dL, Adj. Odds ratio 1.37 (95% CI 1.07 - 1.75).

Conclusion: Open nephrolithotomy had good stone free rate even though the operation had some complications. This technique can be used with more confidence in stone free rate in patient who had high serum creatinine.