«Fast track» postoperative strategy in patients after percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is a main approach to large and staghorn kidney stones, which has almost totally replaced open surgery and extracorporeal lithotripsy as monotherapy. New methods in complicated planned surgical interventions reduce the postoperative complications, hospital stay and accelerate the rehabilitation of patients. Fast-track conception followed this way. The aim of our study was to ground the practicability of this conception in patients after PCNL. Eighty three patients were included in a period from January 2015 to December 2015, from those 53 patients matched the inclusion criteria. First group included 23 patients (mean age 46.4 years, range 19-62), which were “fast-tracked”. The second group consisted of 30 patients with mean age 48.4 (23-67) years with standard approach (control group). Mean hospital stay was 27.3 hours if first group and 54.1 hours in second group. Mean operation time was the same. No complication > Clavien II were evident. Complication rate was similar in groups and low. Stone free rate did not differ significantly among groups, 91% and 90%. Fast-track strategy during PCNL allows reduction of the treatment costs and minimize the spread of hospital flora. The proper patient selection could exclude the increase of intraoperative and postoperative complications.