Journal List > Korean J Urol > v.48(1) > 1004906

Kwon and Kim: A Comparative Study between Standard and Tubeless Percutaneous Nephrolithotomy

Abstract

Purpose:

To compare the clinical parameters and complications between standard and tubeless percutaneous nephrolithotomies (PCNL). The purpose of this study was to assess the efficacy, safety and morbidity of a tubeless percutaneous nephrolithotomy.

Materials and Methods:

A total of 102 patients, who underwent a PCNL at our institution by one surgeon, were enrolled in this study. Of the 102 patients, 30 underwent a standard PCNL between January 2001 and July 2002, and 72 underwent a tubeless PCNL between July 2002 and March 2005. All the PCNL were performed using a balloon tract dilator and 30Fr. working sheath. In the standard PCNL group, a 12Fr. nephrostomy tube was inserted. In the tubeless PCNL group, no nephrostomy tube was inserted, with the skin sutured onto the site of the nephrostomy. The stone volume, operating time, amount of blood loss, complications and hospital stay were compared between the two groups.

Results:

There were no significant differences in stone volumes, decrease in postoperative 1 day hemoglobin, transfusion rates and complication rates between the two groups. However, the postoperative hemoglobin (p=0.05) and hospital stay (p=0.001) were significantly less in the tubeless compared to the standard PCNL group.

Conclusions:

The tubeless PCNL was associated with no more bleeding or complications than the standard PCNL. Tubeless PCNL is a recom- mendable procedure in percutaneous renal stone surgery. (Korean J Urol 2007;48:45-48)

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Table 1.
Parameters of the patients with standard and tubeless PCNL
  Standard Tubeless
Age (years) 51.6 (23-77) 54.7 (12-78)
  Sex
  Male 22 57
  Female 8 15
Operation site
  Right 12 34
  Left 18 37
  Bilateral   1
Renal stone 20 41
Staghorn stone 6 11
Ureter stone 1 16
Ureter+renal stone 3 4
Mutiplicity
  Single 14 38
  Multiple 16 34
Stone volume (cm3) 5.52 (0.94-38.7) 6.0 (0.56-48.4)
No. of ports
  1 26 64
  2 2 7
  3 2 1
Total 30 72

PCNL: percutaneous nephrolithotomy

Table 2.
Comparison of the parameters between standard and tubeless PCNL
  Standard Tubeless p-value
Operating time (min.) 96.3 90.7 0.454
Preoperative Hgb (g/dl) 14.28 14.23 0.885
Decrease of Hgb (g/dl)
  Immediate postoperative 1.43 0.79 0.05
  POD #1 1.89 1.73 0.527
Postoperative hospital stay (days) 4.43 3.38 0.001
Fever (patients) 8 9 0.255
Transfusion (patients) 5 6 0.082

PCNL: percutaneous nephrolithotomy

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