Randomized prospective trial of tubeless versus conventional minimally invasive percutaneous nephrolithotomy

Lu, Yong; Ping, Jigen; Zhao, Xiaojun; Hu, Lingli; Pu, Jinxian

doi:10.1007/s00345-012-0921-2

Cited by 30 publications

(22 citation statements)

References 15 publications

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“…A randomized prospective trial evaluated the efficacy and safety of tubeless (JJ stent but no nephrostomy drainage tubes) versus conventional mini-PCNL (JJ stent and drainage tubes). [ 25 ] In this series with 32 patients, the tubeless mini-PCNL group had significantly shorter hospital stays and experienced significantly less back pain than the conventional mini-PCNL group. There were no significant differences in operation time, stone clearance and complications.…”

Section: Techniquementioning

confidence: 88%

Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literature

Ferakis

Stavropoulos

2015

Urol Ann

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The aim of this review is to present the most recent data regarding the indications of mini percutaneous nephrolithotomy (PCNL), the results and the complications of the method. Medline was searched from 1997 to January 2014, restricted to English language. The Medline search used a strategy including medical subject headings and free-text protocols. PCNL is a well-established treatment option for patients with large and complex renal calculi. In order to decrease morbidity associated with larger instruments like blood loss, postoperative pain and potential renal damage, a modification of the technique of standard PCNL has been developed. This is performed with a miniature endoscope via a small percutaneous tract (11–20 F) and was named as minimally invasive or mini-PCNL. This method was initially described as an alternative percutaneous approach to large renal stones in a pediatric patient population. Furthermore, it has become a treatment option for adults as well, and it is used as a treatment for calculi of various sizes and locations. However, the terminology has not been standardized yet, and the procedure lacks a clear definition. Nevertheless, mini-PCNL can achieve comparable stone-free rates to the conventional method, even for large stones. It is a safe procedure, and no major complications are reported. Although less invasiveness has not been clearly demonstrated so far, mini-PCNL is usually related to less blood loss and shorter hospital stay than the standard method.

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Section: Techniquementioning

confidence: 88%

Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literature

Ferakis

Stavropoulos

2015

Urol Ann

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“…However, routine use in all patients was hypothesised to be a major contributor to patient discomfort and increased LOS. Several studies have since shown the tubeless approach is not only safe and effective, but leads to decreased postoperative pain, analgesia use, LOS and cost . While there have been several series reporting tubeless PCNL to be safe and effective in the elderly (age >60 years) , children (age <16 years) and in patients with renal anomalies , to our knowledge there has been only one study evaluating tubeless PCNL in obese patients.…”

Section: Discussionmentioning

confidence: 99%

Does body mass index impact the outcomes of tubeless percutaneous nephrolithotomy?

et al. 2014

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Objective• To evaluate whether body mass index (BMI) has an impact on the outcomes of tubeless percutaneous nephrolithotomy (PCNL). Patients and Methods• We retrospectively reviewed patients who underwent tubeless PCNL at our institution from 2006 to 2011.• Specifically, stone-free rates, complications, and hospital length of stay (LOS) were assessed. • Patients were divided into four groups based on BMI: <25, 25-29.9, 30-34.9 and ≥35 kg/m 2 .• Baseline characteristics and outcomes were compared between BMI groups. Multivariable logistic regressions were used to evaluate the independent contribution of BMI as a predictor of outcomes. Results• We identified 268 patients who fulfilled study requirements. The overall stone-free and complication rates were 52.5% and 19.0%, respectively.• Minor and severe complication comprised 10.4% and 8.6%, respectively. • Univariate and multivariable analyses showed no association between BMI and stone-free or complication rates.• However, patients with a normal BMI had significantly higher transfusion rates (P = 0.005), and were significantly more likely to have a prolonged LOS (≥2 days), when compared with an overweight BMI (P = 0.032) Conclusions• BMI did not impact the stone-free, or complication rates of tubeless PCNL.• Normal BMI was found to be a risk factor for prolonged LOS, which may be due to an increase in clinically significant bleeding in this patient population. Tubeless PCNL appears to be a safe and effective procedure for the treatment of complex renal calculi, independent of BMI.

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“…Leakage and fever were the most common postoperative complications in five patients (7.5%) and six patients (20%), respectively. Hung et al [10] reported leakage in two patients (4.9%) and fever in five patients (12.1%), and Lu et al [11] reported leakage in 3.1% and fever in 15.6% post-MIPNL.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, Chinese minimally invasive (MIPNL) is defined as a PNL technique with small working sheath, which is performed using an 8-9.8 Fr URS through a 16 Fr percutaneous renal access tract, this is technique was used also by other [10,11].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

et al. 2019

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Background: The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results: Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18-68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm 2 (mean ± SD 172.48 ± 69.54 mm 2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion: Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

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Randomized prospective trial of tubeless versus conventional minimally invasive percutaneous nephrolithotomy

Abstract: No significant differences were found between conventional and tubeless mPCNL in safety issues and stone clearance rate. However, patients treated with tubeless mPCNL had shorter hospitalization stays and were less likely to experience back pain.

Cited by 30 publications

References 15 publications

Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literature

Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literature

Does body mass index impact the outcomes of tubeless percutaneous nephrolithotomy?

Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

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