Abstract
PurposeTo compare the characteristics and outcomes of exit strategies following percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database.Materials and methodsTwo matched data sets were prepared in order to compare stent only versus NT only and TTL versus NT only. Patients were matched on the exit strategy using the following variables: case volume of the center where they underwent PCNL, stone burden, the presence of staghorn stone, size of sheath used at percutaneous access, the presence of bleeding during surgery, and treatment success status. For categorical variables, percentages were calculated and differences between the four groups were tested by the chi-square test.ResultsThe only significant difference reported between the matched pairs was between NT and stent only groups. NT only PCNL was associated with significantly longer operating times (p = 0.029) and longer hospital stay (p < 0.001) than stent only PCNL.ConclusionsPatients who undergo PCNL with less invasive exit strategy involving a stent only have shorter hospital stay than those who have postoperative NT. The intraoperative course is the primary driver of complications in PCNL and not necessarily the exit strategy.
Highlights
Percutaneous nephrolithotomy (PCNL) is the recommended treatment option for large or otherwise complex renal or proximal ureteral stones [1]
Patients were matched on the exit strategy using the following variables: case volume of the center where they underwent percutaneous nephrolithotomy (PCNL), stone burden, the presence of staghorn stone, size of sheath used at percutaneous access, the presence of bleeding during surgery, and treatment success status
This study is conducted on behalf of the Clinical Research Office of the Endourological Society (CROES) PCNL study group
Summary
Percutaneous nephrolithotomy (PCNL) is the recommended treatment option for large or otherwise complex renal or proximal ureteral stones [1]. The standard PCNL procedure involves creating a narrow percutaneous access. Klingler Department of Urology, Medical University of Vienna, Vienna, Austria. Stolzenburg Department of Urology, University of Leipzig, Leipzig, Germany. World J Urol (2013) 31:1239–1244 to the kidney and the formation of a working tract connecting the flank surface with the intrarenal collecting system through which nephroscopy is performed. This allows endoscopic stone disintegration and removal of the stone fragments. A temporary nephrostomy tube (NT) is usually left in place at the end of the procedure to allow urinary drainage, tamponade of tract bleeding, and to maintain access to the collecting system should delayed ‘‘second-look’’ nephroscopy be necessary
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