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Comparative Study
. 2024 Oct 7;24(1):216.
doi: 10.1186/s12894-024-01610-9.

Is double-J stent mandatory in complete supine percutaneous nephrolithotomy for adult patients with staghorn renal stones?

Siavash Falahatkar  1 , Samaneh Esmaeili  1 , Samira Kazemi  2 , Fatemeh Sheikhi  1 , Hosna Norouzi  1
Affiliations
Comparative Study

Is double-J stent mandatory in complete supine percutaneous nephrolithotomy for adult patients with staghorn renal stones?

Siavash Falahatkar et al. BMC Urol. .

Abstract

Background: It is controversial whether double-J (DJ) stent insertion is necessary in tubeless percutaneous nephrolithotomy (PCNL) for patients with staghorn stones. We compared the outcomes of using ureteral catheters and double-J stents in tubeless complete supine PCNL (csPCNL) of staghorn stones.

Methods: In this analytical cross-sectional study, from May 2008 to August 2022, 123 patients who underwent tubeless csPCNL were assessed. Patients were divided into two groups by either tubeless csPCNL with DJ stent (Group I; n = 23) or totally tubeless just with perioperative ureteral stent (Group II; n = 100). Demographic characteristics, stone-related factors, perioperative and postoperative parameters were compared in groups.

Results: Baseline characteristics were comparable in groups. The operative time in group I was significantly longer than group II (68.26 vs. 55.25 min, P = 0.05). However, the duration of hospitalization in Group I was shorter than the other group (1.81 vs. 2.37 days, P = 0.03). Stone free rate was notably higher in Group I (90.5% vs. 79.8.0%) with no statistically significant difference. No significant differences were found in major complications. Patients in Group II had a significantly shorter time to return to normal life (6.48 vs. 7.91 day; P = 0.043). Multivariable linear regression showed the preoperative creatinine level and stone size can affect the operative time (P = 0.02). In addition, stone number and underlying disease can affect the length of hospital stay (P = 0.007 & 0.030, respectively).

Conclusion: Although not inserting a double J stent after csPCNL has acceptable results, because of higher residual rate in staghorn stone which cause more incidence of renal colic, longer time of hospital stay and return to normal life, inserting DJ stent is recommended.

Keywords: Double-J stent; Percutaneous nephrolithotomy (PCNL); Staghorn stones; Supine PCNL; Ureteral catheter.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
STROBE flow chart of eligible patients
Fig. 2
Fig. 2
left: Patient underwent PCNL in complete supine position; right: Surgeon in sitting position during csPCNL
See this image and copyright information in PMC

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