Comparative Study of ‘Percutaneous Nephrolithotomy Placement’ Versus Percutaneous Nephrolithotomy Without Nephrostomy Placement (Tubeless Pcnl)

Abstract

To assess the efficacy, safety, and morbidity of tubeless percutaneous nephrolithotomy (PCNL) and compare it with standard PCNL. METHODOLOGY: Between august 2008 and December 2008 patients undergoing PCNL prospectively evaluated in two groups. One group patients undergone PCNL with nephrostomy placement (Standard PCNL) and second group of patients undergone PCNL without nephrostomy tube (TUBELESS PCNL). Case selection criteria were adequately matched and postoperative outcome was recorded in same way in both groups. Patients who needed more than two percutaneous tracts, intraoperative perforation of the pelvicalyceal system, excessive manipulation at the ureteropelvic junction, or a residual stone after the procedure and who had a solitary kidney or azotemia were excluded from the study. RESULTS: A total 43 patients (23 patients in group I, 22 patients in group II) were included in the study. Post-operative plain x-ray of kidneys, ureters and bladder showed a 100% stone clearance rate. There was no tract related problems i.e., tract infection and sinus formation. Mean hospital stay was 5.9 days in group I and 4.1days in group II. Post-operative ultrasonography during hospitalization showed no perinephric collection. No readmissions to the hospital at mean follow up of 6 months (range 2to 6 months). All patients were doing well. CONCUSIONS: Avoiding the use of nephrostomy or D-J stent may not compromise the safety of PCNL and it decreases morbidity of the patient.