Tubeless vs standard percutaneous nephrolithotomy: a meta‐analysis

Wang, Jiawu; Zhao, Chen; Zhang, Chengyao; Fan, Xiaodong; Yang, Lin; Jiang, Qing

doi:10.1111/j.1464-410x.2011.10463.x

Cited by 63 publications

(33 citation statements)

References 19 publications

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“…15 There have been significant advances in the percutaneous extraction of renal calculi. [2][3][4][5][6][7][8][9][10] Review articles have highlighted the need for minimal intra-operative bleeding, negligible residual stone burden, and one to two attempts at renal access when considering tubeless approaches. Recently, the ability to perform tubeless PCNL as an outpatient procedure has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Since its description in the 1970s, 1 surgical and technological advances have obviated the need for routine nephrostomy tube placement. [2][3][4][5][6][7][8] Tubeless PCNL, with ureteral stenting, has been shown to decrease patients' analgesic requirements and hospital length of stay. 9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management.…”

Section: Introductionmentioning

confidence: 99%

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Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

McAlpine

Leveridge

Beiko

2015

CUAJ

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Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney. IntroductionPercutaneous nephrolithotomy (PCNL) is an accepted and widely used approach to extract large renal calculi. Since its description in the 1970s, 1 surgical and technological advances have obviated the need for routine nephrostomy tube placement.2-8 Tubeless PCNL, with ureteral stenting, has been shown to decrease patients' analgesic requirements and hospital length of stay.9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management. 11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient. Case reportA 49-year-old female presented to her community hospital with hematuria and lower abdominal pain over the preceding 48 hours. She had received her second cadaveric kidney transplant 6 years previously for end-stage renal disease of unknown etiology. On presentation she was afebrile and hemodynamically stable. Urine was positive for blood, but negative for nitrites or pyuria. Creatinine was 164 μmol/L (estimated glomular filtration rate 29 mL/min/1.73m 2 ), slightly elevated from her baseline of 150 μmol/L. An ultrasound scan showed a large renal stone in the lower pole of the allograft kidney. Intravenous antibiotics were initiated and the patient was transferred to our tertiary care centre.At our institution, a computed tomography scan revealed a 14 × 12 × 11-mm stone located in the renal pelvis (Fig. 1a, Fig. 1b). There was mild hydronephrosis, yet the parenchyma of the graft was preserved. There was no evidence of a urinary tract infection (UTI)/sepsis and the patient's pain responded to oral analgesia. The surgical options were discussed and a decision was made to proceed with the PCNL. Informed consent was obtained and a 1-week course of levofloxacin was prescribed for UTI prophylaxis.On the morning of the procedure, a stress dose of 100 mg intravenous (IV) hydrocortisone was administered. Cefazolin 1 g IV was given prior to induction of general anesthesia. Flexible cystourethroscopy was performed and a 5Fr openended ureteral catheter was passed up the left transplanted ureteral orifice over a 0.035" guidewire. A Foley catheter was placed to straight drainage and the patient was repositioned supine for percutaneous access. Retrograde ureteropyelography outlined the allograft kidney's collecting system, demonstrating renal...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

McAlpine

Leveridge

Beiko

2015

CUAJ

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“…3 Numerous studies have supported the use of the tubeless method as a viable alternative to standard PCNL. 1,[4][5][6][7] The advantages of tubeless PCNL over the standard procedure include reduced postoperative analgesic requirements, as well as reduced duration of hospitalization without an increase the rate of complications. Surgical advancements have enabled the use of tubeless PCNL in complex cases, including pediatric, geriatric and bilateral simultaneous renal calculi.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies to date have demonstrated that this is a safe and effective method of stone burden clearance in select patients. 1,[3][4][5][6][7] Recently, tubeless PCNL, on an outpatient basis, has been reported. 8,9 This case report is the first to describe a case of outpatient bilateral tubeless PCNL in a patient with bilateral large staghorn calculi.…”

Section: Introductionmentioning

confidence: 99%

Outpatient bilateral supracostal tubeless percutaneous nephrolithotomy for staghorn calculi

Kokorovic

Wilson

Beiko

2014

CUAJ

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Percutaneous nephrolithotomy (PCNL) is the surgical procedure of choice to treat staghorn calculi. Most centres perform PCNL as the traditional inpatient procedure. However, outpatient PCNL has been successfully attempted and represents a feasible method of reducing hospital costs. We report the case of a 35-year-old female who underwent outpatient simultaneous PCNL for bilateral renal staghorn calculi. The patient was discharged in stable condition less than 3 hours following the procedure with minimal discomfort. To the best of our knowledge, this case report is the first to describe a successfully completed outpatient bilateral supracostal tubeless PCNL for staghorn calculi.

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“…2,9 PCNL has significant advantages in renal calculi extraction such as: need for minimal intra-operative bleeding, high stone-free rate, and renal access by one or maximum two attempts in tubeless approaches. 9,23,24 In our case, the patient had a large stone in the renal pelvis. We performed tubeless PCNL for him [ and removed the stone completely.…”

Section: 391121mentioning

confidence: 99%

Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

et al. 2016

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Urinary lithiasis in transplanted kidney is a relatively uncommon complication. However, it may lead to a significant morbidity and loss of renal function. The report presents the case of a 32-year-old male renal-transplant recipient, with a stone in renal pelvis who was treated successfully by tubeless percutaneous nephrolithotomy (PCNL). The patient is currently stone free with no complication. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed, it could be noticed that PCNL is a safe and feasible procedure for treating nephrolithiasis in a transplanted kidney.

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Tubeless vs standard percutaneous nephrolithotomy: a meta‐analysis

Cited by 63 publications

References 19 publications

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

Outpatient bilateral supracostal tubeless percutaneous nephrolithotomy for staghorn calculi

Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

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