Evaluation of Pleural Following after Percutaneous Nephrolithotomy: An Analysis of 49 Cases

Aim: Thoracic complications developing after percutaneous nephrolithotomy and the efficacy of their treatment were studied. Methods: Among 2527 patients who were operated on using the percutaneous nephrolithotomy technique for kidney stones between November 2003 and August 2014, the medical records of 49 patients who had intrathoracic pathologies after the procedure were retrospectively reviewed. Results: It was observed that pleural effusion developed in 49 patients who were operated with percutaneous nephrolithotomy. The mean age of the patient population was 46.1 years and the age range was 13-85 years. Nineteen (39%) patients were female and 30 (61%) were male. A supracostal intervention was applied in 40 (82%) patients. A subcostal intervention was applied in nine (18%) patients. Seven (78%) of the subcostal interventions were performed above 12th rib and 2 (22%) above 11th rib. After percutaneous nephrolithotomy operation, a hemorrhagic pleural effusion developed in 43 (88%) patients and hydropneumothorax in six (12%) patients. Conclusion: Percutaneous nephrolithotomy is a cause of iatrogenic thoracic complications and pleura and lungs are reportedly the most commonly injured organs. In the case of early postoperative, a posteroanterior chest x-ray should be obtained for an early diagnosis of thoracic complications. Tube thoracostomy usually suffices for these types of complications.