2 research outputs found
Neurologic complications in percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for
the removal of large renal stones in Iran since 1990. Recently, we encountered a series
of devastating neurologic complications during PCNL, including paraplegia and
hemiplegia. There are several reports of neurologic complications following PCNL owing
to paradoxical air emboli, but there are no reports of paraplegia following PCNL.
Materials and Methods: We retrospectively reviewed the medical records of patients
who had undergone PCNL in 13 different endourologic centers and retrieved data related
to neurologic complications after PCNL, including coma, paraplegia, hemiplegia,
and quadriplegia.
Results: The total number of PCNL procedures in these 13 centers was 30,666. Among
these procedures, 11 cases were complicated by neurologic events, and four of these cases
experienced paraplegia. All events happened with the patient in the prone position
with the use of general anesthesia and in the presence of air injection. There were no
reports of neurologic complications in PCNL procedures performed with the patient
under general anesthesia and in the prone position and with contrast injection.
Conclusions: It can be assumed that using room air to opacify the collecting system
played a major role in the occurrence of these complications. Likewise, the prone position
and general anesthesia may predispose to these events in the presence of air
injectio