A Randomized Comparison of Tubeless and Standard Percutaneous Nephrolithotomy

Agrawal, Mukul; Agrawal, Mayank; Gupta, Apurva; Bansal, Sumit; Yadav, Abhishek; Goyal, Jitendra

doi:10.1089/end.2007.0118

Cited by 115 publications

(119 citation statements)

References 26 publications

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“…Since this report, several other investigators have confirmed that tubeless PCNL leads to shorter hospital stays and less postoperative pain (16,18,19) and decreased cost as compared to nephrostomy tube drainage (7,20). While most studies have utilized a ureteral stent in patients undergoing a tubeless PCNL, other investigators have recommended a "totally tubeless" approach (21,22).…”

Section: Discussionmentioning

confidence: 87%

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Introduction: Tubeless PCNL has been utilized to shorten hospital stay and improve patient postoperative pain control. Prior studies have excluded those patients with significant bleeding or other complications. Our objective was to evaluate the utility of tubeless PCNL in all patients irrespective of intraoperative outcome. Materials and Methods:A retrospective review of the charts of patients who underwent PCNL at our institute was performed. Patients were assigned to one endourologist who routinely performed tubeless PCNL and to a second endourologist who routinely left a small-bore pigtail nephrostomy. Preoperative demographics operative and postoperative outcomes were compared. Results: Out of 159 patients included, 83 patients had tubeless PCNL while 76 patients had standard PCNL. There was no difference between groups regarding age, gender, ASA score, number, maximum diameter of stones, number of calyces involved, stone density (HU), laterality and use of preoperative narcotics. While staghorn stones were more common in patients who underwent standard PCNL (p = 0.008). Tubeless patients had less number of access tracts (p ≤ 0.001), shorter hospital stay (1.7 vs. 3.0 days, p = 0.001) when compared to standard PCNL group. Multivariable analysis controlling for confounding factors including staghorn calculi and number of accesses confirmed that tubeless PCNL was associated with shorter hospital stay and less postoperative pain. There was no significant difference in complication rates between the two groups. Conclusion: Our report confirms the previous reports of shorter hospital stay, less pain and analgesia as compared to standard PCNL, and establishes its safety irrespective of bleeding, perforation, extravasation or other intraoperative issues that have previously been utilized as exclusionary criteria for this approach.

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Section: Discussionmentioning

confidence: 87%

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

et al. 2014

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“…8 Literatürde tüpsüz PNL'nin hastanede kalış sü-resini kısalttığını ve analjezi gereksinimini azalttı-ğını vurgulayan birçok çalışma mevcuttur. [10][11][12][13] Standart bir operasyon sonrası takılan nefrostomi tüpünün, özellikle de geniş çaplı kateterlerin, hastanın ameliyat sonrası ağrı skorlarını artırdığı gös-terilmiştir. 3 Agrawal ve ark.nın prospektif, randomize çalışmalarında, tüpsüz hastalarda PNL sonrası ağrının istatistiksel olarak daha az ve hastanede kalış süresinin daha kısa olduğu vurgulanmış, ayrıca gruplar arasında kan kaybı yönünden de fark saptanmadığı bildirilmiştir.…”

Section: Discussionunclassified

“…3 Agrawal ve ark.nın prospektif, randomize çalışmalarında, tüpsüz hastalarda PNL sonrası ağrının istatistiksel olarak daha az ve hastanede kalış süresinin daha kısa olduğu vurgulanmış, ayrıca gruplar arasında kan kaybı yönünden de fark saptanmadığı bildirilmiştir. 13 Çalışmamızda da kan kaybı yönünden iki grup arasında fark bulunamamıştır. Tüpsüz grupta hastanede kalma süresinin daha kısa olduğu görülmüştür.…”

Section: Discussionunclassified

Outcomes of Standard or Tubeless Percutaneous Nephrolithotomy

Aydemi̇r¹,

Budak²

2017

J Reconstr Urol

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“…3,9,17,18 Minimizing drainage tubes inserted at the conclusion of these procedures can decrease pain profile associated with these procedures. Ultimately, there is potential to reduce patient hospital stay due to decreased analgesic requirements.…”

Section: Discussionmentioning

confidence: 99%