title: The Circle Nephrostomy Tube: An Attractive Nephrostomy Drainage System Following Complex Percutaneous Nephrolithotomy.
abstract: OBJECTIVE
  To describe our experience with the circle nephrostomy tube (NT) (Cook Medical), a drainage system uniquely designed for use after multiple-access percutaneous nephrolithotomy (PNL).
  
  
  METHODS
  A retrospective review of 1317 consecutive patients undergoing 1599 PNLs at IU Health Methodist Hospital was performed. All multiple access cases utilizing circle NTs were reviewed and analyzed. The method of insertion of circle NT was demonstrated.
  
  
  RESULTS
  A total of 1843 accesses were obtained in 1599 renal units (RUs): 380 upper pole, 129 interpolar, and 1334 lower pole. Multiple accesses in this series were required in 282 RUs (17.6%). Following multiple-access PNL, circle NTs, Cope loop, and reentry Malecot NTs were inserted in 91 RUs (32.3%), 208 RUs (73.8%), and 31 RUs (11%), respectively. None of the patients who had circle NT experienced clogging, dislodgement, or obstruction of the tube. The cost of circle, Cope loop, and Malecot NTs are 121.73 USD, 95.20 USD, and 81 USD, respectively.
  
  
  CONCLUSIONS
  Circle NTs are easy to insert, secure, cost-effective compared with inserting two NTs. Circle NTs provide excellent drainage and facilitate secondary procedures.
authors.affiliation: Baylor Scott & White Health, Temple, TX.
authors.forename: Marawan M
authors.initials: MM
authors.lastname: El Tayeb
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Borofsky
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN. Electronic address: jlingeman@iuhealth.org.
authors.forename: James E
authors.initials: JE
authors.lastname: Lingeman
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000074642:Nephrolithotomy, Percutaneous / Q000379:methods*; D000074643:Nephrotomy / Q000295:instrumentation / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods