Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison.
OBJECTIVE
To prospectively compare the outcome of standard and tubeless percutaneous nephrolithotomy (PNL) in a selected group of patients with renal stones.


METHODS
Patients with simple, isolated renal pelvis or lower pole caliceal stones and no significant hydronephrosis were randomly enrolled to undergo either standard PNL, in which routine nephrostomy tube was placed at the end of operation, or tubeless PNL. Occurrence of intraoperative complications, total operative time exceeding 2 h, indication for additional access or second-look PNL due to residual stones were exclusion criteria.


RESULTS
There were 11 isolated lower pole caliceal stones (mean stone burden: 3.1 cm(2)) and 6 isolated renal pelvis stones (mean stone burden: 2.8 cm(2)) in the tubeless PNL group (n: 17), and 9 isolated lower pole caliceal stones (mean stone burden: 3.4 cm(2)) and 9 isolated renal pelvis stones (mean stone burden: 3.1 cm(2)) in the standard PNL group (n: 18). Mean operation time was 59.6 +/- 9.1 (range: 50-90) min in the tubeless group, and 67.3 +/- 10.1 (range: 60-115) min in the standard PNL group (P > 0.05). Successful stone removal was achieved in all patients, and no significant complication was observed in any case. The mean postoperative analgesic requirement was significantly less in the tubeless group (P < 0.05). Mean hospital stay was 1.6 +/- 0.4 (range: 1-3) days in the tubeless group, and 2.8 +/- 0.9 (range: 2-4) days in the former group (P < 0.05).


CONCLUSIONS
Our results indicate that tubeless PNL is safe in the management of selected patients and that mean analgesic requirement as well as hospitalization time is diminished with this modification.
Tefekli
Ahmet
A
Department of Urology, Haseki Teaching and Research Hospital, 34096 Haseki, Istanbul, Turkey. atefekli@ttnet.net.tr
Altunrende
Fatih
F
Tepeler
Kadir
K
Tas
Aytul
A
Aydin
Sabahattin
S
Muslumanoglu
Ahmet Y
AY
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011300:Preoperative Care; D011860:Radiography, Abdominal; D016896:Treatment Outcome