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Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

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Abstract

Objectives

To prospectively compare the outcome of standard and tubeless percutaneous nephrolithotomy (PNL) in a selected group of patients with renal stones.

Methods

Patients with simple, isolated renal pelvis or lower pole caliceal stones and no significant hydronephrosis were randomly enrolled to undergo either standard PNL, in which routine nephrostomy tube was placed at the end of operation, or tubeless PNL. Occurrence of intraoperative complications, total operative time exceeding 2 h, indication for additional access or second-look PNL due to residual stones were exclusion criteria.

Results

There were 11 isolated lower pole caliceal stones (mean stone burden: 3.1 cm2) and 6 isolated renal pelvis stones (mean stone burden: 2.8 cm2) in the tubeless PNL group (n: 17), and 9 isolated lower pole caliceal stones (mean stone burden: 3.4 cm2) and 9 isolated renal pelvis stones (mean stone burden: 3.1 cm2) in the standard PNL group (n: 18). Mean operation time was 59.6 ± 9.1 (range: 50–90) min in the tubeless group, and 67.3 ± 10.1 (range: 60–115) min in the standard PNL group (P > 0.05). Successful stone removal was achieved in all patients, and no significant complication was observed in any case. The mean postoperative analgesic requirement was significantly less in the tubeless group (P < 0.05). Mean hospital stay was 1.6 ± 0.4 (range: 1–3) days in the tubeless group, and 2.8 ± 0.9 (range: 2–4) days in the former group (P < 0.05).

Conclusion

Our results indicate that tubeless PNL is safe in the management of selected patients and that mean analgesic requirement as well as hospitalization time is diminished with this modification.

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References

  1. Matlaga BR, Assimos DG (2002) Changing indications of open stone surgery. Urology 59:490–494

    Article  PubMed  Google Scholar 

  2. Matlaga BR, Kim SC, Lingeman JE (2005) Improving outcomes of percutaneous nephrolithotomy: access. Eur Urol EAU Update Series 3:37–43

    Google Scholar 

  3. Davidoff R, Bellman GC (1997) Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol 157:1229–1231

    Article  PubMed  CAS  Google Scholar 

  4. Limb J, Bellman GC (2002) Tubeless percutaneous renal surgery: review of first 112 cases. Urology 59:527–531

    Article  PubMed  Google Scholar 

  5. Feng MI, Tamaddon K, Mikhail A et al (2001) Prospective randomised study of various techniques of percutaneous nephrolithotomy. Urology 58:345–350

    Article  PubMed  CAS  Google Scholar 

  6. Desai MR, Kukreja RA, Desai MM et al (2004) A prospective randomized comparison of type of nephrostomy drainage following percutaneous nephrostolithotomy: large bore versus small bore versus tubeless. J Urol 172:565–567

    Article  PubMed  Google Scholar 

  7. Marcovich R, Jacobson AI, Singh J et al (2004) No panacea for drainage after percutaneous nephrolithotomy. J Endourol 18:743–747

    Article  PubMed  CAS  Google Scholar 

  8. Karami H, Gholamrezaie HR (2004) Totally tubeless␣percutaneous nephrolithotomy in selected cases. J␣Endourol 18:475–476

    Article  PubMed  Google Scholar 

  9. Gupta NP, Kesarwani P, Goel R, Aron M (2005) Tubeless percutaneous nephrolithotomy. A comparative study with standard percutaneous nephrolithotomy. Urol Int 74:58–61

    Article  PubMed  Google Scholar 

  10. Candela J, Daidoff R, Gerspach J, Bellman GC (1997) “Tubeless” percutaneous surgery: a new advance in the technique of percutaneous renal surgery. Tech Urol 3:6–11

    PubMed  CAS  Google Scholar 

  11. Kim S, Tinmouth WW, Kuo RL et al (2005) Using and choosing a nephrostomy tube after percutaneous nephrolithotomy for large or complex stone disease: a treatment strategy. J Endourol 19:348–352

    Article  PubMed  Google Scholar 

  12. Pietrow PK, Auge BK, Lallas CD et al (2003) Pain after percutaneous nephrolithotomy: impact of nephrostomy tube size. J Endourol 17:411–415

    Article  PubMed  Google Scholar 

  13. Maheshwari PN, Andankar MG, Bansal M (2000) Nephrostomy tube after percutaneous nephrolithotomy: large-bore or pigtail catheter? J Endourol 14:735–739

    PubMed  CAS  Google Scholar 

  14. Liatsikos EN, Hom D, Dinlenc CZ et al (2002) Tail stent versus re-entry tube: a randomized comparison␣after percutaneous stone extraction. Urology 59:15–21

    Article  PubMed  Google Scholar 

  15. Bellman GC Daidoff R, Candela J et al (1997) Tubeless percutaneous renal surgery. J Urol 157:1578–1582

    Article  Google Scholar 

  16. Wickham JEA, Miller RA, Kellett MJ et al (1984) Percutaneous nephrostholithotomy: one stage or two? Br J Urol 56:582–584

    Article  PubMed  CAS  Google Scholar 

  17. Winfield HN, Weyman P, Clayman RV (1986) Percutaneous nephrostholithotomy: complications of premature nephrostomy tube removal. J Urol 136:77–79

    PubMed  CAS  Google Scholar 

  18. Bdesha AS, Jones CR, North EA et al (1997) Routine placement of a nephrostomy tube is not necessary after percutaneous nephrostholithotomy. Br J Urol 79(suppl 4):1

    Google Scholar 

  19. Delnay KM, Wake RW (1998) Safety and efficacy of percutaneous nephrostholithotomy. World J Urol 16:375–377

    Article  PubMed  CAS  Google Scholar 

  20. Goh M, Wolf JS (1999) Almost totally tubeless percutaneous nephrolithotomy: further evolution of the technique. J Endourol 13:177–180

    Article  PubMed  CAS  Google Scholar 

  21. Lojanapiwat B, Soonthornphan S, Wudhikarn S (2001) Tubeless percutaneous nephrolithotomy in selected cases. J Endourol 15:711–713

    Article  PubMed  CAS  Google Scholar 

  22. Aghamir SMK, Hosseini SR, Gooran S (2004) Totally tubeless percutaneous nephrolithotomy. J Endourol 18:647–648

    Article  PubMed  CAS  Google Scholar 

  23. Yew J, Bellman G (2003) Modified ‘tubeless’ percutaneous nephrolithotomy using a tail-stent. Urology 62:346–349

    Article  PubMed  Google Scholar 

  24. Aron M, Goel R, Kesarwani PK, Gupta NP (2004) Hemostasis in tubeless PNL: point of technique. Urol Int 73:244–247

    Article  PubMed  Google Scholar 

  25. Jou YC, Cheng MC, Sheen JH, Lin CT, Chen PC (2004) Electrocauterization of bleeding points for percutaneous nephrolithotomy. Urology 64:443–447

    Article  PubMed  Google Scholar 

  26. Gupta V, Sadasukhi TC, Sharma KK, Yadav RG, Mathur R (2005) Tubeless and stentless percutaneous nephrolithotomy. BJU Int 95:905–906

    Article  PubMed  Google Scholar 

  27. Mikhail AA, Kaptein JS, Bellman GC (2003) Use of fibrin glue in percutaneous nephrolithotomy. Urology 61:910–914

    Article  PubMed  Google Scholar 

  28. Lee DI, Uribe C, Eichel L et al (2004) Sealing percutaneous nephrolithotomy tracts with gelatin matrix hemostatic sealent: initial clinical use. J Urol 171:575–578

    Article  PubMed  Google Scholar 

  29. Noller MW, Baughman SM, Morey AF, Auge BK (2004) Fibrin sealent enables tubeless percutaneous stone surgery. J Urol 172:166–169

    Article  PubMed  Google Scholar 

  30. Uribe C, Eichel L, Khonsari S et al (2005) What happens to hemostatic agents in contact with urine? An in vitro study. J Endourol 19:312–317

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Haseki Teaching and Research Hospital, 34096, Haseki, Istanbul, Turkey

    Ahmet Tefekli, Fatih Altunrende, Kadir Tepeler, Aytul Tas, Sabahattin Aydin & Ahmet Y. Muslumanoglu

Authors
  1. Ahmet Tefekli
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  2. Fatih Altunrende
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  3. Kadir Tepeler
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  4. Aytul Tas
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  5. Sabahattin Aydin
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  6. Ahmet Y. Muslumanoglu
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Corresponding author

Correspondence to Ahmet Tefekli.

Additional information

Presented at the 23rd World Congress on Endourology and SWL, August 23–26, 2005, Amsterdam, The Netherlands

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Tefekli, A., Altunrende, F., Tepeler, K. et al. Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison. Int Urol Nephrol 39, 57–63 (2007). https://doi.org/10.1007/s11255-006-9040-6

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  • DOI: https://doi.org/10.1007/s11255-006-9040-6

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