Early postoperative outcomes of open renal stone surgery: A prospective study with 1-month follow-up across 3 referral hospitals in Addis Ababa, Ethiopia

Abstract

Background: The surgical management of urinary tract stone disease has undergone revolutionary changes from open stone surgery to minimally invasive procedures with comparable efficacy. In regions where minimally invasive surgery is not widely accessible, open surgery persists as the primary management approach for urolithiasis. Surgical outcomes for renal stones are primarily evaluated based on the stone clearance rate, the necessity for additional procedures, and postoperative morbidity. This study aimed to ascertain the stone clearance rate and perioperative complications associated with open renal stone surgery.

Methods: This prospective study, conducted at 3 referral hospitals in Addis Ababa, Ethiopia, was conducted over a 1-year period, with patients followed up for 1 month postoperatively to assess outcomes. It included all patients who underwent open surgery for renal stones across the hospitals from 1 June 2020 to 1 June 2021. Data were collected during the preoperative, intraoperative, and postoperative periods using a structured data collection form. Descriptive analyses covered preoperative, intraoperative, and early postoperative data. Categorical variables were analysed using the chi-square test, as appropriate. Two-sided P values <0.05 were considered statistically significant.

Results: Of the 81 patients who underwent open surgery for renal stones, the overall stone clearance rate was 50%. Factors such as stone multiplicity, stone architecture, the absence of intraoperative imaging, and the type of surgery were significantly associated with stone clearance rates. Intraoperatively, blood transfusions were necessary for 3 patients, and pleural injuries were reported in 2. Postoperatively, the incidence of surgical site infections was 9.9%, and the incidence of symptomatic urinary tract infections was 3.3%.

Conclusions: The stone-free rate was found to be lower in patients with large, complex, and multiple stones.