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. 2016;11(4):240-246.
doi: 10.5114/wiitm.2016.64447. Epub 2016 Dec 6.

Modified totally tubeless percutaneous nephrolithotomy: Is it an effective and safe treatment option for renal and upper ureteral stones?

Ho Seok Chung  1 , Seung Il Jung  1 , Ho Song Yu  1 , Eu Chang Hwang  1 , Kyung Jin Oh  1 , Dong Deuk Kwon  1 , Kwangsung Park  1
Affiliations

Modified totally tubeless percutaneous nephrolithotomy: Is it an effective and safe treatment option for renal and upper ureteral stones?

Ho Seok Chung et al. Wideochir Inne Tech Maloinwazyjne. 2016.

Abstract

Introduction: We hypothesized that modified totally tubeless percutaneous nephrolithotomy (PNL) without indwelling ureteral stent would minimize postoperative discomfort without complications.

Aim: To evaluate the safety, efficacy, and morbidity of standard, tubeless, and modified totally tubeless PNL as well as the usefulness of modified totally tubeless PNL.

Material and methods: From November 2011 to February 2015, 211 patients who underwent PNL consecutively were enrolled in this study and divided into 3 groups (group 1: standard, group 2: tubeless, group 3: modified totally tubeless PNL). Patient and stone characteristics, operation time, hemoglobin change, length of hospitalization, stone-free rate, analgesic requirement, and perioperative complications were analyzed and compared among the 3 groups.

Results: There were no significant differences in preoperative patient characteristics among the three groups. In the postoperative analysis, the three groups had similar operation time, stone-free rate, perioperative fever and transfusion rate, but group 2 showed superior results in terms of length of hospitalization (p = 0.001). Group 2 and group 3 had a lower analgesic requirement (p = 0.010). Immediate postoperative hemoglobin change (p = 0.001) and tube site complications (p = 0.001) were more common in group 1.

Conclusions: Modified totally tubeless PNL was not inferior in terms of postoperative outcomes and safety compared with the standard and tubeless PNL, and avoided the postoperative stent-related symptoms and cystoscopy for double-J stent removal. Modified totally tubeless PNL could be an alternative treatment of choice for management of renal or upper ureteral stones in selected patients.

Keywords: percutaneous nephrolithotomy; stone; tubeless.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Photo 1
Photo 1
Technique with PNL. A – Standard PNL (group 1), B – Tubeless PNL (group 2), C – Modified totally tubeless PNL (group 3)
See this image and copyright information in PMC

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