Comparative analysis of hemorrhagic complications in left vs. right kidney during percutaneous nephrolithotomy (PCNL) in central India: A cross-sectional study

Abstract

Introduction: Renal calculi present a substantial healthcare burden globally, necessitating effective management strategies. Percutaneous Nephrolithotomy (PCNL) stands as a cornerstone for addressing kidney stones, offering high efficacy but accompanied by potential complications. This study aimed to comprehensively compare hemorrhagic complications in left vs right kidney during PCNL in a tertiary care hospital in central India. Methods: A cross-sectional study was conducted between January 1st, 2022, and March 31st, 2024, involving 205 patients. 200 PCNL cases were analyzed which included patients > 18 years of age and renal calculi > 2 cm. 5 Patients were excluded with incomplete records, psychiatric problems, sepsis, and distal ureteric obstruction. Data encompassed demographic profiles, stone characteristics, procedural details influencing primary outcomes stone-free rates (SFRs), and post-PCNL complications. Statistical analysis utilized chi-square tests and Fisher’s exact tests. Results: The study comprised 135 males (67.5%) and 65 females (32.5%), with a mean age of 40.99 years.62% of patients experience bleeding on the left side. The primary outcome measure, Stone-Free Rate (SFR), was assessed through postoperative imaging (ultrasound and X-ray. The SFR for the entire cohort was high, indicating the efficacy of the PCNL. Postoperative complications were documented and analyzed, with a focus on bleeding. Conclusion: The study demonstrates that the left kidney showed a significantly higher incidence of hemorrhagic complications (62%) compared to the right kidney (38%). These findings highlight the need for careful preoperative planning and intraoperative management to mitigate the risk of bleeding, especially in patients with left kidney stones.