Login to Access Video or Poster Abstract: MP50-14
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Introduction

Percutaneous Nephrolithotomy (PNL) is a procedure that has traditionally been performed in an inpatient setting with at least an overnight stay. Many surgical procedures have evolved over time from an inpatient setting to an ambulatory surgery center (ASC) setting. Feasibility of Ambulatory PNL (aPNL) was shown in our initial pilot series of 25 cases.¹ This 100 case series is reviewed to further evaluate outcomes with a more robust data set.

Methods

We present a series of our initial 100 patients who underwent PNL in an ASC from April 2015 to October 2016. Each aPNL was performed by a single surgeon with the same operative team. The surgeon and operative team had extensive experience with PNLs performed in a hospital setting. All procedures were performed with the operative surgeon obtaining renal access and all procedures were performed tubeless (ureteral stent without a nephrostomy tube). All patients also had hemostatic plugs placed into the access tract with a local intercostal block performed to aid with pain control.² All cases were reviewed and demographic date and case details were analyzed.

Results

Of the 100 aPNL reviewed (Table 1), there were 50 women, 52 left side, mean age 57 (21-83), mean BMI 30 (19-45), and mean stone burden 27mm (10-110). Stone free rate was 96%. Four patients had complications. One Clavien 4a pulmonary embolism (PE) required a 7 day hospital admission. There were three Clavien 1 presentations (two for pain and the other for nausea) of which two required hospital admission.

Conclusions

This consecutive 100 case series further demonstrates the safety of aPNL. While four patients experienced complications; none of the outcomes of the adverse events were affected by the site of service. The patients experienced complications not uncommon to many types of procedures (post-operative pain and nausea) that were managed with an ER visit or short hospital stay. The PE was managed in a routine manner. With an experienced surgeon, well trained operative team and with modifications to the procedure focusing on post-operative pain control, PNL can be safely and effectively performed in an ASC. Ongoing collaborative data collection is needed to continue to evaluate the safety of aPNL._x000D_ _x000D_ ¹ Davalos JG J Urol April 2016 S1: MP57-11_x000D_ ² Abbott JE J Endourol March 2015_x000D_

Funding

None