Safety and Efficacy of Day-case Percutaneous Nephrolithotomy: A Systematic Review from European Society of Uro-technology

Day case or ambulatory percutaneous nephrolithotomy (PCNL) has risen over the last few years with the aim of discharging patients within 24h.

We perform a systematic review of literature to evaluate the outcomes of day-case PCNL surgery.

A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science Direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. All studies in the English language reporting on PCNL patients discharged within 24h were included.

Based on the literature search of 97 articles, nine (502 patients) met the inclusion criteria (mean age: 47 yr), with a mean stone size of 20.5mm. The mean operating time was 66min, and over a mean hospital stay of 17.5h, the stone-free rate was 95%. The overall complication rate was 13.5%; the vast majority of these complications were Clavien I-II complications, with a readmission rate of 3%.

Day-case PCNL is a safe and feasible strategy in carefully selected cases. However, for its success, detailed planning and adherence to surgical protocol are paramount with strict criteria for inpatient admission and a thorough follow-up plan.

Day-case percutaneous nephrolithotomy procedure seems to be a safe procedure with good outcomes, and low risk of complications and readmissions. Detailed preoperative protocol and planning are paramount, with indications for inpatient admission as well as a thorough follow-up plan.

European urology focus. 2018 Apr 12 [Epub ahead of print]

Patrick Jones, Grace Bennett, Alexios Dosis, Amelia Pietropaolo, Robert Geraghty, Omar Aboumarzouk, Andreas Skolarikos, Bhaskar K Somani

Department of Urology, University Hospital Southampton, Southampton, UK., Department of Urology, Royal Preston Hospital, Preston, UK., Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK; EAU Young Academic Urologists (YAU) Endourology Group, Arnhem, The Netherlands., 2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece; European Association of Uro-technology (ESUT), Arnhem, The Netherlands., Department of Urology, University Hospital Southampton, Southampton, UK; EAU Young Academic Urologists (YAU) Endourology Group, Arnhem, The Netherlands; European Association of Uro-technology (ESUT), Arnhem, The Netherlands. Electronic address: .