title: Tubeless and stentless percutaneous nephrolithotomy in patients requiring supracostal access.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of supracostal access in tubeless and stentless percutaneous nephrolithotomy (PCNL).
  
  
  METHODS
  From March 2005 to June 2007, 10 patients underwent tubeless and stentless PCNL via supracostal access. Patients requiring more than 2 percutaneous tracts, or those with significant intraoperative bleeding were excluded from the study. Perioperative and postoperative outcomes for these patients (the study group) were compared with those of a similar number of patients who underwent unilateral PCNL via an intercostal approach with routine placement of a nephrostomy tube before March 2005 (the control group). The 2 groups had a comparable demographic data.
  
  
  RESULTS
  Patients undergoing tubeless and stentless PCNL required less analgesia (p = 0.001) and were discharged earlier (p = 0.000) than were those in the control group. The difference in the mean decrease in hemoglobin concentration was not statistically significant.
  
  
  CONCLUSIONS
  Supracostal access in tubeless and stentless PCNL appears to be safe and feasible, offering the advantages of a lower need for analgesia and a shorter hospital stay without increasing thoracic complications.
authors.affiliation: Urology Clinic, Baskent University Konya Hospital, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Gonen
authors.forename: Tufan
authors.initials: T
authors.lastname: Cicek
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardes
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*