Pre- and post-operative safety considerations for patients undergoing percutaneous nephrolithotomy

Coman R.A. Tzelves L. Juliebø-Jones P. Talyshinskii A. Nedbal C. Ventimiglia E. Davis N. Somani B.K.
2025 Taylor and Francis Ltd.

Expert Opinion on Drug Safety
2025 #24 Issue 12 1367 - 1381 pp.

Introduction: Percutaneous nephrolithotomy (PCNL) is a widely used surgical procedure for treating large and complex kidney stones. Although effective, it carries risks of complications such as bleeding, infection, and injury to adjacent structures. Optimization of procedural techniques and perioperative care can help minimize these risks. Areas covered: This review examines key pre- and post-operative safety considerations for PCNL patients. Topics include pre-operative imaging, patient positioning, puncture techniques, tract dilation, postoperative drainage, and complication management. The literature search involved analyzing recent studies and clinical guidelines to identify best practices. The search was conducted in several databases, including PubMed, Embase, the Cochrane Library and clinical guidelines. Training modalities for improving procedural skills are discussed. Expert opinion: Improving the safety of PCNL requires a combination of meticulous surgical technique, proper patient selection, and adherence to standardized protocols. Continuous skill development and technological advancements will further improve patient outcomes.

complications , fragmentation , kidney calculi , laser , nephrostomy , PCNL

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Medlife Humanitas Hospital, Cluj, Romania
2nd University Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Attica, Athens, Greece
Urology, Haukeland University Hospital, Bergen, Norway
Department of Urology, Astana Medical University, Astana, Astana, Kazakhstan
Department of Urology, ASST Fatebenefratelli Sacco, Lombardy, Milan, Italy
Urological Research Institute, University Vita Salute San Raffaele, Milano, Italy
Department of Urology, Royal College of Surgeons in Ireland, Leinster, Dublin, Ireland
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom

Medlife Humanitas Hospital
2nd University Department of Urology
Urology
Department of Urology
Department of Urology
Urological Research Institute
Department of Urology
Department of Urology

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