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Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from The Global PCNL Study from The Clinical Research Office Endourology Society

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Abstract

Purpose

To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL).

Methods

The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at 96 participating centers worldwide. This report focuses on the 3,968 patients who received a NT of known size. Preoperative, surgical procedure and outcome data were analyzed according to NT size, dividing patients into two groups, namely small-bore (SB; nephrostomy size ≤ 18 Fr) and large-bore (LB; nephrostomy size > 18 Fr) NT.

Results

Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P < 0.001), overall complications (15.8 vs. 21.4 %; P < 0.001) and a trend toward a lower rate of fever (9.1 vs. 10.7 %). Patients receiving a LB NT conversely had a statistically, though not clinically significant, longer postoperative hospital stay (4.4 vs. 4.2 days; P = 0.027). There were no differences in urinary leakage (0.9 vs. 1.3 %, P = 0.215) or stone-free rates (79.5 vs. 78.1 %, P = 0.281) between the two groups.

Conclusions

LB NTs seem to reduce bleeding and overall complication rate. These findings would suggest that if a NT has to be placed, it should better be a LB one.

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Acknowledgments

The Global PCNL Study was supported by an unrestricted educational grant from Olympus.

Conflict of interest

No competing financial interests exist.

Author information

Authors and Affiliations

  1. Department of Urology, University of Foggia, Foggia, Italy

    Luigi Cormio

  2. Department of Urology, Duke University Medical Center, Durham, NC, USA

    Glenn Preminger

  3. Department of Urology, University of Strasbourg, Strasbourg, France

    Christian Saussine

  4. Department of Urology, Barts & The London NHS Trust, London, UK

    Niels Peter Buchholz

  5. Department of Urology, Peking University First Hospital, Beijing, China

    Xiaochun Zhang

  6. Department of Urology, University Hospital, Orebro, Sweden

    Helena Walfridsson

  7. Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany

    Andreas J. Gross

  8. Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam Z-O, The Netherlands

    Jean de la Rosette

Authors
  1. Luigi Cormio
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  2. Glenn Preminger
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  3. Christian Saussine
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  4. Niels Peter Buchholz
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  5. Xiaochun Zhang
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  6. Helena Walfridsson
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  7. Andreas J. Gross
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  8. Jean de la Rosette
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Corresponding author

Correspondence to Jean de la Rosette.

Additional information

This study was conducted on behalf of the CROES PCNL Study Group.

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Cormio, L., Preminger, G., Saussine, C. et al. Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from The Global PCNL Study from The Clinical Research Office Endourology Society. World J Urol 31, 1563–1568 (2013). https://doi.org/10.1007/s00345-012-0969-z

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  • DOI: https://doi.org/10.1007/s00345-012-0969-z

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