title: Totally tubeless percutaneous nephrolithotomy: selecting for success in children.
abstract: BACKGROUND
  The placement of a nephrostomy tube or internal ureteral stent after PCNL has been considered standard practice.
  
  
  OBJECTIVE
  To investigate the inclusion criteria for totally tubeless PCNL in pediatric cases.
  
  
  METHODS
  A total of 27 children who underwent PCNL included in the study: Twelve of the 27 patients who underwent totally tubeless PCNL (group 1; tubeless and stentless), and the remaining 15 patients underwent Standard PCNL (group 2; tube with or without stent). Whether or not to perform totally tubeless technique was decided intraoperatively. The length of hospitalization, drop in hemoglobin level, the operation time, stone burden and the fluoroscopy time of group 1 and 2 were compared statistically. Also stone free and complication rates were evaluated in both groups.
  
  
  RESULTS
  The mean age was 5 years and 9.5 years in group 1 and 2, respectively (p = 0.01). The mean operative time was 15.83 min in group 1, and 48.6 min in group 2 (p = 0.0001). The mean change in hemoglobin levels between preoperative and postoperative measurements was -1.83 mg/dl for group 1, and -5.2 mg/dl for group 2 (p = 0.0001). No blood transfusion was needed during or after the operation in any cases for group 1. The mean length of hospital stay was 1.83 day in group 1 and 5.53 day in group 2 (p = 0.001). Stone free rate for group 1 was 100% (12/12) and 93.3% (14/15) for group 2. There were no major operative or postoperative complications in both groups.
  
  
  CONCLUSIONS
  Provided an optimal patient selection, the success and safety rates of PCNL's performed via totally tubeless technique are similar to those.
authors.affiliation: Department of Urology, Ministry of Health, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Hasan Nedim Goksel
authors.initials: HN
authors.lastname: Goktug
authors.forename: Suleyman
authors.initials: S
authors.lastname: Yesıl
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ozturk
authors.forename: Can
authors.initials: C
authors.lastname: Tuygun
authors.forename: M Abdurrahim
authors.initials: MA
authors.lastname: Imamoglu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D018579:Patient Selection; D012008:Recurrence; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins