Complications in Percutaneous Nephrolithotomy
Rebeca Escobar Monroy, Silvia Proietti, Federico De Leonardis, Stefano Gisone, Riccardo Scalia, L. Mongelli, Franco Gaboardi, Guido Giusti
Abstract
Purpose: Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for large renal calculi. Despite its efficacy, complications can occur. This narrative review aims to classify, manage, and prevent PCNL complications, emphasizing risk factors and strategies to optimize outcomes. Findings: PCNL is a safe and highly effective procedure for the management of renal stones. Risk factors include patient comorbidities, stone complexity, prolonged surgical time, and improper access. Proactive measures, such as accurate imaging, antibiotic prophylaxis, and careful surgical techniques, reduce complication rates. Although certain complications may affect surgical outcomes, most are effectively managed through conservative or minimally invasive approaches. Proficiency in the technique is essential for reducing the risk of complications. Conclusions: Understanding the classification, risk factors, and management of PCNL complications is essential for optimizing patient outcomes. Comprehensive preoperative planning, meticulous surgical technique, and tailored postoperative care are critical for minimizing risks and improving procedural safety.