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World Journal of Urology

, Volume 31, Issue 6, pp 1563–1568 | Cite as

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

  • Luigi Cormio
  • Glenn Preminger
  • Christian Saussine
  • Niels Peter Buchholz
  • Xiaochun Zhang
  • Helena Walfridsson
  • Andreas J. Gross
  • Jean de la RosetteEmail author
Original Article

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.

Keywords

Exit strategy Nephrostomy tube size Renal access Complications PCNL 

Notes

Acknowledgments

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

Conflict of interest

No competing financial interests exist.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Luigi Cormio
    • 1
  • Glenn Preminger
    • 2
  • Christian Saussine
    • 3
  • Niels Peter Buchholz
    • 4
  • Xiaochun Zhang
    • 5
  • Helena Walfridsson
    • 6
  • Andreas J. Gross
    • 7
  • Jean de la Rosette
    • 8
    Email author
  1. 1.Department of UrologyUniversity of FoggiaFoggiaItaly
  2. 2.Department of UrologyDuke University Medical CenterDurhamUSA
  3. 3.Department of UrologyUniversity of StrasbourgStrasbourgFrance
  4. 4.Department of UrologyBarts & The London NHS TrustLondonUK
  5. 5.Department of UrologyPeking University First HospitalBeijingChina
  6. 6.Department of UrologyUniversity HospitalOrebroSweden
  7. 7.Department of UrologyAsklepios Hospital BarmbekHamburgGermany
  8. 8.Department of UrologyAMC University HospitalAmsterdam Z-OThe Netherlands

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