DOI: https://doi.org/10.36347/sasjs.2024.v10i08.016

Pages: 981-987

Background: Percutaneous nephrolithotomy (PCNL) is an established method for renal stone removal. Due to the high recurrence rate of renal stones, patients previously treated with open renal stone surgery often require re-intervention. Open surgeries can result in scar tissue and anatomical changes that may affect subsequent PCNL procedures. Objective: The study aimed to compare the outcomes of PCNL in patients with and without a history of open renal stone surgery. Method: This prospective study was conducted at Dhaka Medical College Hospital and Dhaka Central International Medical College Hospital from October 2019 to September 2020. Sixty patients with renal stone disease scheduled for PCNL were selected based on inclusion and exclusion criteria. They were divided into two groups: Group A (n=30) comprised patients without a history of open renal stone surgery. At the same time, Group B (n=30) included those with a history of open renal stone surgery. Results: No significant differences were found between the groups regarding age, sex, number, size, or location of stones. Group B required more puncture attempts to access the collecting system (3.63 ± 1.06 vs. 1.56 ± 0.71, p < 0.001). Although the operation time was longer in Group B (106.83 ± 21.63 vs. 102.33 ± 24.76 minutes), it was not statistically significant (p=0.49). Blood transfusion was more frequently required in Group B (26.66% vs. 13.33%, p=0.02). No significant differences were observed in the number of tracts (p=1.00), perioperative complications, postoperative fever (p=0.64), or hospital stay (p=0.48). Stone clearance rates were 90.0% in Group B and 93.33% in Group A (p=0.64). Conclusion: PCNL in patients with a history of open renal stone surgery requires more puncture attempts and blood transfusions than in those without such a history. However, stone clearance rates are comparable between the two groups.