• Danniel Frade Said, Daniel Beltrame Ferreira, HayekKayann Kaled Reda ElKKRE0000-0002-3262-4550Hospital de Transplantes Dr. Euryclides de Jesus Zerbini, Division of Urology - São Paulo (SP), Brazil., Rodrigo Perrella, Priscila Kuriki Vieira Mota, David Jacques Cohen, Carlos Alfredo Batagello, Claudio Bovolenta Murta, Joaquim Francisco de A Claro, and Fabio Carvalho Vicentini.
• Hospital de Transplantes Dr. Euryclides de Jesus Zerbini, Division of Urology - São Paulo (SP), Brazil.
• Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (5): e20221089e20221089.

ObjectiveThe aim of this study was to identify predictive factors for complications after percutaneous nephrolithotomy.MethodsWe prospectively analyzed patients who underwent percutaneous nephrolithotomy from June 2011 to October 2018. The association of preoperative and intraoperative factors with the presence of complications was assessed using univariate and multivariate analyses. The significance level was set at p<0.05.ResultsA total of 1,066 surgeries were evaluated, and the overall complication rate was 14.9%. In all, 105 (9.8%) surgeries were performed in the prone position, and 961 (90.2%) were performed in the supine position. Univariate analysis demonstrated that surgical position, upper pole puncture, surgical time, number of tracts, and Guys Stone Score were associated with complications. In multivariate analyses, prone position (odds ratio [OR] 2.10; p=0.003), surgical time ≥90 min (OR 1.76; p=0.014), upper pole puncture (OR 2.48; p<0.001), and Guys Stone Score 3 or 4 (OR 1.90; p=0.033) were independent predictive factors for complications after percutaneous nephrolithotomy.ConclusionPerforming percutaneous nephrolithotomy in the supine position, in under 90 min, and avoiding upper pole punctures may reduce complications during the treatment of large kidney stones.

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