Percutaneous Nephrolithotomy (PCNL): Standard Technique Versus Tubeless - 125 Procedures.
complications
hospitalization duration
nephrostomy
pcnl
percutaneous nephrolithotomy
postoperative pain
tubeless
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
14 Mar 2019
14 Mar 2019
Historique:
entrez:
28
5
2019
pubmed:
28
5
2019
medline:
28
5
2019
Statut:
epublish
Résumé
Tubeless percutaneous nephrolithotomy (PCNL) is the non-placement of a nephrostomy tube at the end of the procedure. The benefits of a nephrostomy tube placement are numerous as it provides adequate renal drainage. It may also tamponade bleeding and allow for an easier second-look nephroscopy. However, these advantages are mostly theoretical, and the majority of authors consider the nephrostomy tube as a source of morbidity. The aim of this report was to study the efficiency, safety, and morbidity of tubeless PCNL by comparing it to the standard technique. This is a unicentric retrospective study of 125 patients who had undergone PCNL for renal lithiasis. We divided the patients into two groups: the standard PCNL group (n = 74) and the tubeless PCNL group (n = 51). The rates of good outcomes, complications, duration of hospitalization, and the degree of postoperative pain were compared between these two groups. There were no statistically significant differences between the two groups in age, gender, history, and the number of stones treated. There were more staghorn stones in the PCNL group with nephrostomy (p = 0.007) and more pelvicalyceal stones in the tubeless group (p = 0.037). Patients who had the standard PCNL had larger stones (p = 0.008). Patients who had a tubeless PCNL had more postoperative infectious complications than the standard PCNL group (p = 0.042). No statistically significant differences were noted for other complications, good outcomes (p = 0.13), postoperative pain (p = 0.51), and duration of hospitalization (p = 0.16). According to the majority of authors, tubeless PCNL is considered a safe and efficient technique. It also provides advantages with less postoperative pain and duration of hospitalization. We believe that a selection bias may exist in most published work concerning routine nephrostomy tube placement.
Identifiants
pubmed: 31131174
doi: 10.7759/cureus.4251
pmc: PMC6516629
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e4251Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Urology. 2001 Sep;58(3):345-50
pubmed: 11549477
J Endourol. 2001 Sep;15(7):711-3
pubmed: 11697402
Urology. 2004 Jun;63(6):1036-40; discussion 1040-1
pubmed: 15183942
J Urol. 2004 Aug;172(2):565-7
pubmed: 15247731
Ann Urol (Paris). 2006 Jun;40(3):149-60
pubmed: 16869536
Int Urol Nephrol. 2007;39(1):57-63
pubmed: 17171416
J Endourol. 2006 Dec;20(12):1016-21
pubmed: 17206894
J Endourol. 2008 Mar;22(3):439-42
pubmed: 18257738
J Endourol. 2008 Mar;22(3):427-34
pubmed: 18355137
J Urol. 2008 Aug;180(2):612-4
pubmed: 18554657
J Endourol. 2008 Jul;22(7):1441-6
pubmed: 18690810
J Endourol. 2008 Sep;22(9):1865-7; discussion 1869
pubmed: 18811471
Prog Urol. 2008 Dec;18(12):901-7
pubmed: 19033051
Urology. 2010 May;75(5):1043-6
pubmed: 19854490
Eur Urol. 2012 Jan;61(1):164-70
pubmed: 21570174
World J Urol. 2013 Oct;31(5):1303-7
pubmed: 22903789
Urolithiasis. 2013 Aug;41(4):347-53
pubmed: 23632910
Urolithiasis. 2014 Jun;42(3):255-62
pubmed: 24468916
Int Braz J Urol. 2014 Mar-Apr;40(2):204-11
pubmed: 24856487
J Endourol. 2016 Dec;30(12):1275-1284
pubmed: 27736198
J Endourol. 2017 Nov;31(11):1131-1138
pubmed: 28891320
Indian J Urol. 2017 Oct-Dec;33(4):310-314
pubmed: 29021656
J Urol. 1997 May;157(5):1578-82
pubmed: 9112480