Comparative study of the outcome of tubed versus tubeless percutaneous nephrolithotomy

Keywords: renal stone, percutaneous nephrolithotomy, tubed, tubeless, outcome.

Abstract

Percutaneous nephrolithotom (PCNL) is the best choice in treating renal stones currently. The PCNL is followed by placement of nephrostomy tube and stent that help in tamponade of percutaneous tract. Tubeless PCNL is accompanied by less postoperative pain and shorter hospital stay. Despite advantages of tubeless PCNL, some surgeonsstill excluded bleeding or residual stone patients, no chance of second look which increase chance of missing residual stone fragments, requiring often an additional procedures like cystoscopy, stent dysuria and risk of no drainage for kidney.

This study aimed to compare the effectiveness and safety of tubeless PCNL to tubed PCNL.

Methods: A prospective comparative study conducted in Urology department of Safeer Al-Imam Al-Hussein in Karbala, from January 2013, 1stto  December, 31th 2017. One thousand four hundreds thirty four patients with renal stones surgically operated with PCNL were categorized into two groups; 882 patients with renal stones were treated with tubed PCNL and 552 patients were treated with tubeless PCNL.

Results: The young age female were predominantly related to tubeless PCNL. Left sided stones with lucent and upper approach were significantly associated with tubeless PCNL. The tubed PCNL was significantly related to right side stone, while tubeless PCNL was significantly related to left side stone (p = 0.006). Tubeless PCNL was significantly associated with lucent opacity more than tubed PCNL (p = 0.001). Postoperatively, tubeless PCNL was significantly associated with lower rates of residual stone (p = 0.005), bleeding (p = 0.04) and sepsis (p = 0.01) compared to tubed PCNL.

Conclusion: The tubeless option is effective and safe modality for PCNL.The low rate of residual stones and postoperative bleeding and sepsis can safely have associated with Tubeless PCNL.

Downloads

Download data is not yet available.

References

Kumar S, Karthikeyan VS, Mallya A, Keshavamurthy R. Outcomes of second-look percutaneous nephrolithotomy in renal calculi-a single center experience. Turk J Urol 2018; 44(5):406-410.doi: 10.5152/tud.2018.76299

Isac W, Rizkala E, Liu X, Noble M, Monga M. Tubeless percutaneous nephrolithotomy: outcomes with expanded indications. Int Braz J Urol 2014; 40(2):204-211. doi: 10.1590/S1677-5538.IBJU.2014.02.10

Al-Aridy HM. Percutaneous nephrolithotomy for renal calculi: A single surgeon experience. The Iraqi Postgraduate Medical Journal 2013; 12 (4): 573-580. Available from: https://www.iasj.net/iasj?func=fulltext&aId=86749

Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Percutaneous approaches to the upper urinary tract collecting system. Campbell – Walsh Urology. 10th ed. Vol. 2. Philadelphia: Saunders Elsevier; 2012: 1023-1752.eBook ISBN: 9781455723171

Srinivasan AK, Herati A, Okeke Z, Smith AD: Renal drainage after percutaneous nephrolithotomy. J Endourol 2009; 23: 1743-1749.doi: 10.1089/end.2009.1545

Armitage JN, Irving SO, Burgess NA: British Association of Urological Surgeons Section of Endourology: Percutaneous nephrolithotomy in the United Kingdom: results of a prospective data registry. Eur Urol 2012; 61: 1188-1193. doi: 10.1016/j.eururo.2012.01.003

Nakamon T, Kitirattrakarn P, Lojanapiwat B. Outcomes of percutaneous nephrolithotomy: comparison of elderly and younger patients. Int Braz J Urol 2013; 39(5):692-700; discussion 701. doi: 10.1590/S1677-5538.IBJU.2013.05.12

Irving S, Wiseman O, Finch W, Armitage J, Fowler S, Withington J, et al. Is PCNL a safe and effective option for octogenarian patient? Analysis of over 4000 cases from a national database. The Journal of Urology 2017; 197 (4S): e351. doi: 10.1016/j.juro.2017.02.844

Zehri AA, Biyabani SR, Siddiqui KM, Memon A. Triggers of blood transfusion in percutaneous nephrolithotomy. J Coll Physicians Surg Pak 2011; 21(3):138-141. doi: 03.2011/JCPSP.138141

Khan A, Rahiman M, Verma A, Bhargava R.  Tubeless percutaneous nephrolithotomy: is it the present standard of care? International Surgery Journal 2017; 4(1):117-120.doi: 10.18203/2349-2902.isj20164403

Giusti G, Piccinelli A, Maugeri O, Benetti A, Taverna G, Graziotti P. Percutaneous nephrolithotomy: tubeless or not tubeless? Urol Res 2009; 37(3):153-158. doi: 10.1007/s00240-009-0183-7

Sourial MW, Francois N, Box GN, Knudsen BE. Supracostal access tubeless percutaneous nephrolithotomy: minimizing complications. World J Urol 2018. doi: 10.1007/s00345-018-2518-x. [Epub ahead of print] doi: 10.1007/s00345-018-2518-x

Balandi SS. Tubeless versus standard percutaneous nephrolithotomy at Duhok Province, Iraq. Duhok Medical Journal 2017;11(1):49-59. Available from:https://www.iasj.net/iasj?func=fulltext&aId=161594

Karadag MA, Cecen K, Demir A, Kocaaslan R, Taken K, Altunrende F. Tubeless Percutaneous Nephrolithotomy: Can be a Choice, Why Not? The Open Urology & Nephrology Journal 2014;7:4-7.doi: 10.2174/1874303X01407010004

Lee JY, Jeh SU, Kim MD, Hyuk-Kang D, Kwon JK, Ham WS, et al. Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials. BMC Urol 2017; 17(1):48. doi: 10.1186/s12894-017-0239-x

Lai W-H, Jou Y-C, Cheng M-C, Shen C-H, Lin C-T, Chen P-C, et al. Tubeless percutaneous nephrolithotomy: Experience of 1000 cases at a single institute. Urological Science 2017; 28; 23e26.doi:10.1016/j.urols.2016.04.004

Sharma K, Sankhwar SN, Goel A, Singh V, Sharma P, Garg Y. Factors predicting infectious complications following percutaneous nephrolithotomy. Urol Ann 2016; 8(4):434-438.doi: 10.4103/0974-7796.192105

Eslahi A, Irani D, Hosseini MM, Safarpour AR. Totally Tubeless Percutaneous Nephrolithotomy: A Comparison with Tubeless and Standard Methods.  Nephro-Urol Mon 2017; 9(4):e60079.doi: 10.5812/numonthly.60079


Abstract views: 349
PDF Downloads: 16090
Published
2019-06-06
How to Cite
aal-Toma, R. R. J. (2019). Comparative study of the outcome of tubed versus tubeless percutaneous nephrolithotomy. Ukrainian Journal of Nephrology and Dialysis, (2(62), 18-23. https://doi.org/10.31450/ukrjnd.2(62).2019.03