Comparison of totally tubeless percutaneous nephrolithotomy and standard
percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial
#MMPMID27007650
Moosanejad N
; Firouzian A
; Hashemi SA
; Bahari M
; Fazli M
Braz J Med Biol Res
2016[]; 49
(4
): e4878
PMID27007650
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This study aimed to compare the totally tubeless percutaneous nephrolithotomy and
standard percutaneous nephrolithotomy techniques regarding their rates of success
and complications in patients with kidney stones. Patients were randomly assigned
to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years) received
totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or
ureteral catheter after PCNL) and 40 patients (18 men; mean age: 49.95 ± 13.38
years) underwent standard PCNL (a nephrostomy catheter and ureteral catheter were
used after PCNL). All surgeries were performed by one surgeon. Postoperative
changes in hemoglobin, the blood transfusion rate, changes in creatinine levels,
operation time, analgesic need, hospitalization time, and complication rate were
compared between the groups. No significant differences were observed in age,
gender, stone size, and surgery side between the groups (P<0.05). The operation
time was significantly lower in the totally tubeless PCNL group than in the
standard PCNL group (P=0.005). Pethidine requirements were significantly higher
in the standard PCNL group than the totally tubeless PCNL group (P=0.007).
Hospitalization time was significantly higher in the standard PCNL group than in
the totally tubeless PCNL group (P<0.0001). The complication rate was 15% in the
standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73). The
totally tubeless PCNL technique is safe and effective, even for patients with
staghorn stones. This technique is associated with decreased pain, analgesic
needs, and operative and hospitalization time. We believe that a normal
peristaltic ureter is the best drainage tube.
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