Abstract
Objective:To prospectively compare the feasibility and safety of tubeless percutaneous nephrolithotomy (PCNL) Vs standard PCNL. Patients and methods:220 patients undergoing PCNL were randomized to two groups: Group A (tubeless PCNL) with antegrade placement of a Double-J stent without nephrostomy and group B (standard PCNL) with nephrostomy tube placement postoperatively with 110 patients in each group.Inclusion criteria were stone size more than 2 cm, single tract puncture with complete clearance, less than three stones with a diameter Results:There was no significant difference between the two groups for patient demographics and stone characteristics. There was no statistically significant difference between the two groups for the complications, stone clearance, need for ancillary procedure, mean postoperative drop in haemoglobin, need for blood transfusion. The mean postoperative ana;gesic requirement, operative time and hospital stay was statistically significantly higher in the tubeless PCNL group compared with the standard PCNL group with p values of 0.000, 0.040, 0.001 respectively. Conclusion:Tubeless PCNL is considered a safe and efficient technique in any tract location (upper, middle, lower), in patients with bilateral disease and effective procedure if done in a selected group of patients.
Highlights
Urinary stones are defined as polycrystalline aggregates composed of variable amounts of crystal and organic matrix components
Tubeless if stone < 3 cm Standard percutaneous nephrolithotomy (PCNL): The procedure length and higher complication rates showcase the difficulties encountered in this group of patients
PCNL has the advantage in the management of large renal stones of decreasing morbidity and hospital stay in comparison to open surgery 11
Summary
Urinary stones are defined as polycrystalline aggregates composed of variable amounts of crystal and organic matrix components. The occurrence of stone disease is 2 to 3 times more in young males than females in the past this difference is declining. The estimated prevalence of the renal stone disease is 1% to 5%. Soucie et al proposed that the prevalence of the stone disease is 10% in males and 4% in females 1. Whites are commonly affected than Asians and Afro-Americans. The incidence of stone disease is highest in the fourth to sixth decades. Obesity and sedentary lifestyle predispose to stone formation
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