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Effectiveness of totally tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized study

  • Urology - Original Paper
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Abstract

Objectives

Compared with the standard technique, the number of percutaneous nephrolithotomy (PCNL) operations without a drainage catheter is increasing in recent years. In this prospective randomized study, we compared the morbidity of totally tubeless (tubeless and stentless) PCNL operations with the standard operation technique in a single center with a selected patient population.

Methods

Ninety patients who fulfilled the criteria were included. Forty-five patients underwent totally tubeless PCNL (Group 1) and a 14F malecot nephrostomy catheter was used in another set of 45 patients (Group 2). Inclusion criteria for the study were no serious bleeding or perforation in the collecting system during the operation, stone free or clinically insignificant residual fragments (CIRF <4 mm), and no more than one access.

Results

When two groups were compared with regard to age, stone volume, postoperative hemoglobin change, transfusion rate, and operation time, no significant differences were found between the two groups. However, a significant difference was found in hospitalization time between the two groups (P < 0.05). The amount of non-steroidal analgesic (tenoxicam) needed and non-steroidal analgesia-resistant pain which was resolved with narcotic analgesics (meperidine) were significantly lower in Group 1 (P < 0.05). Complications were observed in two patients (4.5%) in Group 1 (one retroperitoneal hematoma, one long-lasting renal colic) and in six patients (13.3%) in Group 2 (five prolonged urine drainage, one long-lasting fever) (P < 0.05).

Conclusions

Tubeless and stentless PCNL is a safe method and reduces hospitalization time and analgesic requirement, and promotes quality of life in selected patients.

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References

  1. Tefekli A, Altunrende F, Tepeler K et al (2006) Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison. Int Urol Nephrol 39:57–63. doi:10.1007/s11255-006-9040-6

    Article  PubMed  Google Scholar 

  2. Shah HN, Kausık VB, Hegde SS et al (2005) Tubeless percutaneous nephrolithotomy: a prospective feasibility study and review of previous reports. BJU Int 96:879–883. doi:10.1111/j.1464-410X.2005.05730.x

    Article  PubMed  Google Scholar 

  3. Aghamir SM, Hosseini SR, Gooran S (2004) Totally tubeless percutaneous nephrolithotomy. J Endourol 18:647–648. doi:10.1089/end.2004.18.647

    Article  PubMed  CAS  Google Scholar 

  4. Karami H, Gholamrezaie HR (2004) Totally tubeless percutaneous nephrolithotomy in selected cases. J Endourol 18:475–476. doi:10.1089/0892779041271580

    Article  PubMed  Google Scholar 

  5. Wickham JE, Miller RA, Kellett MJ et al (1984) Percutaneous nephrolithotomy: one stage or two? Br J Urol 56:582–585

    Article  PubMed  CAS  Google Scholar 

  6. Winfield HN, Weyman P, Clayman RV (1986) Percutaneous nephrostolithotomy: complications of premature nephrostomy tube removal. J Urol 136:77–79

    PubMed  CAS  Google Scholar 

  7. Bdesha AS, Jones CR, North EA et al (1997) Routine placement of a nephrostomy tube is not necessary after percutaneous nephrostolithotomy. Br J Urol 79:1

    Google Scholar 

  8. Gupta V, Sadasukhi TC, Sharma KK et al (2005) Tubeless and stentless percutaneous nephrolithotomy. BJU Int 95:905–906. doi:10.1111/j.1464-410X.2005.05432.x

    Article  PubMed  Google Scholar 

  9. Karami H, Arbab AH, Hosseini SJ et al (2006) Impacted upper-ureteral calculi >1 cm: blind access and totally tubeless percutaneous antegrade removal or retrograde approach? J Endourol 20:616–619. doi:10.1089/end.2006.20.616

    Article  PubMed  Google Scholar 

  10. Aghamir SM, Khazaeli MH, Meisami A (2006) Use of surgicel for sealing nephrostomy tract after totally tubeless percutaneous nephrolithotomy. J Endourol 20:293–295. doi:10.1089/end.2006.20.293

    Article  PubMed  CAS  Google Scholar 

  11. Istanbulluoglu OM, Ozturk B, Cicek T et al (2008) Case report: bilateral simultaneous tubeless and stentless percutaneous nephrolithotomy. J Endourol 22:25–28. doi:10.1089/end.2007.0037

    Article  PubMed  Google Scholar 

  12. Crook TJ, Lockyer CR, Keoghane SR et al (2008) Totally tubeless percutaneous nephrolithotomy. J Endourol 22:267–272. doi:10.1089/end.2006.0034

    Article  PubMed  Google Scholar 

  13. Bellman GC, Davidoff R, Candela J et al (1997) Tubeless percutaneous renal surgery. J Urol 157:1578–1582. doi:10.1016/S0022-5347(01)64799-2

    Article  PubMed  CAS  Google Scholar 

  14. Rana AM, Mithani S (2007) Tubeless percutaneous nephrolithotomy: call of the day. J Endourol 21:169–172. doi:10.1089/end.2006.0192

    Article  PubMed  Google Scholar 

  15. Al-Ba’adani HT, Al-Kohlany KM, Al-Adimi A et al. (2007) Tubeless percutaneous nephrolithotomy: the new gold standard. Int Urol Nephrol 40:603–608

  16. Noller MW, Baughman SM, Morey AF et al (2004) Fibrin sealant enables tubeless percutaneous stone surgery. J Urol 172:166–169. doi:10.1097/01.ju.0000129211.71193.28

    Article  PubMed  Google Scholar 

  17. Nagele U, Schilling D, Anastasiadis AG et al (2006) Closing the tract of mini-percutaneous nephrolithotomy with gelatine matrix hemostatic sealant can replace nephrostomy tube placement. Urology 68:489–494. doi:10.1016/j.urology.2006.03.081

    Article  PubMed  Google Scholar 

  18. Lee DI, Uribe C, Eichel L et al (2004) Sealing percutaneous nephrolithotomy tracts with gelatin matrix hemostatic sealant: initial clinical use. J Urol 171:575–578. doi:10.1097/01.ju.0000103501.98597.b7

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Baskent University School of Medicine, Selçuklu, 42060, Konya, Turkey

    Mustafa Okan Istanbulluoglu, Bulent Ozturk, Murat Gonen, Tufan Cıcek & Hakan Ozkardes

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  1. Mustafa Okan Istanbulluoglu
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  2. Bulent Ozturk
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  3. Murat Gonen
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  4. Tufan Cıcek
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  5. Hakan Ozkardes
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Correspondence to Mustafa Okan Istanbulluoglu.

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Istanbulluoglu, M.O., Ozturk, B., Gonen, M. et al. Effectiveness of totally tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized study. Int Urol Nephrol 41, 541–545 (2009). https://doi.org/10.1007/s11255-008-9517-6

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  • DOI: https://doi.org/10.1007/s11255-008-9517-6

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