Kết quả chu phẫu của tán sỏi thận qua da đường hầm nhỏ ở bệnh nhân sỏi thận có nhiễm khuẩn niệu trước phẫu thuật

Abstract

Objective: To evaluate the perioperative outcomes of mini-percutaneous nephrolithotomy (mini-PCNL) in patients with kidney stones and a history of urinary tract infection (UTI). Subject and method: A prospective cross-sectional descriptive study was conducted on 41 patients with kidney stones and previous UTI who underwent mini-PCNL at 108 Military Central Hospital from October 2024 to March 2025. Evaluated parameters included microbiological characteristics, duration of preoperative antibiotic treatment, surgical techniques, postoperative complications, and stone-free outcomes. Results: Escherichia coli was the most common pathogen (48.5%). The mean duration of preoperative antibiotic therapy was 9.8 ± 3.1 days. The middle calyx was the main puncture site (65.9%), and most patients required only a single tract (90.2%). Mean operative time was 51.10 ± 12.42 minutes, with no intraoperative complications recorded. The postoperative complication rate was 22%, mainly fever (17.1%) and urinary tract infection (4.9%), with no Clavien–Dindo grade III or higher complications. The stone-free rate was 78.0%, and overall outcomes were good in 80.5% of patients. Conclusion: Mini-PCNL is a safe and effective treatment for kidney stones in patients with a history of UTI when infection is adequately controlled before surgery. Appropriate antibiotic therapy combined with urinary drainage when indicated plays an important role in reducing complications and improving surgical outcomes.