Percutaneous Nephrolithotomy Safety, Efficacy, and Outcomes: A 10-Year Experience of a Tertiary Care Center in South Lebanon

Percutaneous nephrolithotomy (PCNL) is the gold standard for treating large and complex renal stones. This study presents a comprehensive analysis of 221 PCNL procedures performed over a decade (2014-2024) at a tertiary healthcare center in South Lebanon, focusing on safety, efficacy, and factors influencing outcomes. Patients aged 15-80 years were included, with variables such as stone characteristics, operative details, and postoperative outcomes analyzed. The mean patient age was 50 ± 16 years. The mean stone size was 3.1 ± 1.1 cm, with single stones most common (n = 82, 37.1%). The mean operative time was 2.1 ± 0.9 hours, and the average postoperative hospital stay was 2.7 ± 1.2 days. Complication rates were low (3.6%), with only one grade IV complication reported. The stone-free rate one month postoperatively was 82.35% (n = 182), with a mean residual stone size of 0.81 ± 0.32 cm, and only 8.1% (n = 18) of patients required second interventions. Regression analysis highlighted the significant influence of surgical team experience on reducing operative time, while larger stone sizes were associated with longer procedures. Compared to international benchmarks, the study demonstrated shorter operative times, lower complication rates, and comparable stone-free outcomes, emphasizing the role of expertise, advanced technologies, and structured preoperative protocols. These findings underscore the safety and efficacy of PCNL in the studied population. The study calls for the establishment of universal benchmarks for PCNL safety and efficacy, alongside multicenter studies, to optimize clinical practices and standardize outcomes for better patient care globally.