Hemostasis in tubeless PNL: point of technique.
BACKGROUND
Tubeless PNL (percutaneous nephrolithotomy), in a highly selected group of patients, is a modification aimed at reducing the morbidity of PNL. We present a simple technique of achieving tract hemostasis as an adjunct to the safe performance of a tubeless PNL.


METHODS
Charts of 40 consecutive patients who underwent tubeless PNL at our center were reviewed. In the latter 20 consecutive patients, diathermy coagulation of the intrarenal bleeders and tract was done and these patients were compared with the earlier 20 patients in whom fulguration was not done. Drop in hemoglobin, postoperative analgesic requirement, operating time, length of hospitalization and postoperative complications were compared.


RESULTS
No statistical difference was found between the operative times and drop in hemoglobin for both the groups. The length of hospitalization and postoperative analgesic requirement were significantly less in the fulguration group. No significant complications were noted in either of the two groups.


CONCLUSIONS
Fulguration of visible intrarenal and tract bleeders is a simple, safe and effective hemostatic adjunct in patients undergoing tubeless PNL.
Aron
Monish
M
Department of Urology, All India Institute of Medical Sciences, New Delhi, India. monisharon@hotmail.com
Goel
Rajiv
R
Kesarwani
Pawan K
PK
Gupta
Narmada P
NP
D000328:Adult; D004564:Electrocoagulation; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000601:surgery*