PCNL under local anesthesia with 3-week placement of nephrostomy tube before operation: A local study

Abstract

Aim: To show feasibility and safety of PNL under local anesthesia and benefit of placement of nephrostomy tub before 3 week. Patient and Methods:40 Patients selected from multi center in Iraq in our study with renal stone and those patient have major medical problem that prevent general or regional anesthesia so we have put a nephrostomy tube before 3 week of PCNL.Infiltration of nephrostomy tract deeply reaching parenchyma with lignocaine 2% unde u/s guide and infiltration of subcostal nerve also then proceed to enter pcs. Study done in multicenter Al Yarmouk teaching hospital, Al safer privet hospital, Imam Zhen Al Abdeen hospital, and. Medical city hospital. Study started June 2018 end December 2020. 25 Patients have 25_40 mm renal pelvic stone, 5 patient have 15 impacted PUJ stone 5 Patients have single kidney with impacted renal pelvic stone 20mm. Other 5 patients uremic with impacted upper ureteric stone where unrolled in our study. All patients monitored for: Pain during operation; Bleeding during and post; Access feasibility; Stone clearance; Time of operation; Radiation time. Result:10% of patients feel little discomfort relived by paracetamol vial I.V No significant bleeding during procedure. Easy access and no difficulty. 96% clearance of the stone. Mean time of operation 20__ 50 minutes. Conclusion: Placement of nephrostomy tub 3 week before PCNL make the operation easy and-decrease the time of operation, no radiation exposure less bleeding and you can make any position mainly lateral. Keyword: PCNL under local anesthesia, sever comorbidity with renal stone, renal stone with nephrostomy.