title: Is tubeless percutaneous nephrolithotomy a feasible technique for the treatment of staghorn calculi?
abstract: OBJECTIVE
  Tubeless percutaneous nephrolithotomy (PNL) remains a challenging technique for the surgical treatment of staghorn renal calculi. Our study was designed to compare surgical outcomes between conventional and tubeless PNL.
  
  
  METHODS
  We retrospectively enrolled consecutive patients who underwent conventional or tubeless PNL under general anesthesia performed by a single surgeon (H.J.) for the treatment of staghorn calculi between 2003 and 2012. All patients were divided into two groups: group 1 included patients who underwent conventional PNL and group 2 included patients who were managed by tubeless PNL for the treatment of staghorn calculi. Preoperative and postoperative parameters were analyzed between the two groups, including age, stone burden, complications, any interventions, and duration of hospital stay.
  
  
  RESULTS
  A total of 165 patients (group 1, 106; group 2, 59) were enrolled in the study. No significant differences in age, sex, body mass index, or stone laterality were observed between the two groups. The mean stone burdens (±standard deviation) of group 1 and group 2 were 633.6 (±667.4) and 529.9 (±362.8), respectively (p=0.271). The postoperative stone-free clearance rate was higher in group 2 (78.0%) than in group 1 (69.8%); however, the difference was not clinically significant (p=0.127). In addition, no significant differences in postoperative complications, including fever, bleeding, infection, or additional interventions, were observed between the two groups.
  
  
  CONCLUSIONS
  Our results demonstrated that tubeless PNL has the same effectiveness and safety as conventional PNL in the treatment of staghorn calculi. Tubeless PNL may be feasible for managing renal staghorn calculi.
authors.affiliation: Department of Urology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sang Cheol
authors.initials: SC
authors.lastname: Lee
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Kim
authors.forename: Kwang Taek
authors.initials: KT
authors.lastname: Kim
authors.forename: Tae Beom
authors.initials: TB
authors.lastname: Kim
authors.forename: Khae Hawn
authors.initials: KH
authors.lastname: Kim
authors.forename: Han
authors.initials: H
authors.lastname: Jung
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Jin Kyu
authors.initials: JK
authors.lastname: Oh
keywords: Kidney calculi; Nephrolithotomy; Percutaneous nephrostomy