Analysis of the Feasibility and Efficacy of Ambulatory/Day Care Percutaneous Nephrolithotomy: An Initial Experience

Sharma, Adittya K; Nagabhushan, M; Girish, G; Kamath, Amita; Ratkal, CS; Venkatesh, Giridhar

doi:10.3834/uij.1944-5784.2013.08.03

Cited by 3 publications

(5 citation statements)

References 18 publications

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“…In our study, 91.4% of patients were completely cleared off the stone, which was similar to studies by Ahmed Fahmy et al (SFR-90.7%) and El Taby et al (SFR-91.7%) [19,21]. In studies by Iqbal Singh et al, and Sharma et al, 100% stone clearance was achieved [22,24].…”

Section: Discussionsupporting

confidence: 90%

“…The readmission rate is 8.6% (n = 6), similar to the studies by Fahmy et al, (9.8%) [21] and Sharma et al (15%) [22], and it is better than El-Tabey et al study (28.6%) [19]. Two patients (2.9%) in our study had sepsis and were treated with higher antibiotic (intravenous Inj.Meropenem 1 g) and responded effectively.…”

Section: Discussionsupporting

confidence: 88%

“…The mean hospital stay in our study was 17.25 ± 11.23 h with the earliest discharge at 7 h and maximum being 60 h. The mean hospital stay in El-Tabey et al and Iqbal Singh et al studies was 33.4 ± 17.5 h (24-96 h) and 40 h which showed longer hospital stay than our study [19,24]. In Sharma et al (12.5 h, range 5.5-23.5) and Ahmed et al (9 h), the average hospital stay was shorter as they excluded the duration of stay of the re-admitted patients and calculated the average from the patients discharged as day-care [21,22].…”

Section: Discussioncontrasting

confidence: 49%

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Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

et al. 2021

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Background To evaluate the safety, feasibility of mini-percutaneous nephrolithotomy (mPCNL) being carried out as a daycare surgery and to study the re-admission, stone clearance rate and complication rates following mPCNL. We also sought to find out the rate of requirement of ancillary procedure, after mPCNL. Methods In this prospective observational study, easily accessible patients above 18 years of age with renal and/or upper ureteric calculi, who underwent mPCNL between September 2018 and February 2020, were included. Seventy patients were selected, as per statistical methods. Preoperative evaluation including history, blood and urine investigations and radiological images was collected. Intra-operative and post-operative events were analyzed. Written consent was obtained from the patients to participate in the study and to publish their data. Institutional Ethical and scientific committee clearance was obtained. Results Out of 70 patients who underwent mPCNL in the study, in the age group ranging from 24–68 years, most of the cases were partial staghorn with maximum size of stone up to about 3.5 cm. Inferior calyx was most frequently punctured. Six cases had multipuncture mPCNL, four patients had bilateral procedure, and two had supra-costal puncture. Eighteen patients had tubeless mPCNL, of which four were totally tubeless procedures. Four patients had hematuria, none requiring transfusion. Two patients had sepsis, managed with higher antibiotics. Limitation of the study was the sample size. To derive a sturdy conclusion, large scale studies are recommended. Conclusions We can conclude that mPCNL can be safely done as daycare or ambulatory surgery in properly selected patients. In centers with experienced urologists, bilateral and multipuncture mPCNL can be done as an ambulatory surgery. Thus, this addresses the stone disease as well as cost containment, without patient safety being compromised. Bed occupancy rate is reduced, helping effective utilization of hospital resources.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 49%

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Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

et al. 2021

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“…In our study, 90.2% (55/61) of the cases who were initially randomized to the DCS group were discharged within 24-hours of the surgery. Sharma and colleagues reported that 85% of their preoperatively selected cases could successfully complete the study protocol and were discharged within 24 hours of surgery [ 19 ]. Alyami et al reported that 66% of their cases could be safely discharged after an overnight stay [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Day care PNL using 'Santosh-PGI hemostatic seal' versus standard PNL: A randomized controlled study

Kumar

Singh

et al. 2016

CEJU

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IntroductionTo compare the outcomes of tubeless day care PNL using hemostatic seal in the access tract versus standard PNL.Material and methodsIt was a prospective randomized controlled study. Cases were randomized to either the day care group with hemostatic seal (DCS) or the control group where patients were admitted and a nephrostomy tube was placed at the conclusion of surgery.ResultsA total of 180 cases were screened and out of these, 113 were included in the final analysis. The stone clearance rates were comparable in both the groups. The mean drop in hemoglobin was significantly lower in DCS group than the control group (1.05 ±0.68 vs. 1.30 ±0.58 gm/dl, p = 0.038).Mean postoperative pain score, analgesic requirement (paracetamol) and duration of hospital stay were also significantly lower in the DCS group (3.79 ±1.23 vs. 6.12 ±0.96, 1.48 ±0.50 vs. 4.09 ±1.11 grams and 0.48 ±0.26 vs. 4.74 ±1.53 days respectively; p <0.05). The incidence of urine leakage through the access tract site was significantly lower in the DCS subgroup when compared to the controls (3.6% vs. 21.1%, p <0.05). Cases in the DCS group resumed their normal activities in a significantly shorter time (8.05 ±3.05 vs.18.42 ±4.42 days; p <0.05). Higher proportion of cases in the DCS group got re-admitted, although it was not a statistically significant number (7.1% vs. 1.8%; p = 0.21).ConclusionsTubeless day care PNL with composite hemostatic tract seal is considered safe. It resulted in a significant reduction of blood loss and analgesic requirement with significantly reduced hospital stay, nephrostomy tube site morbidity and time required to resume normal activity when compared to the standard PNL. However, patients must be compliant with the given instructions and should have access to a health care facility, as few of them may need re-admission.

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“…From a total of 97 articles, nine (n = 502) were selected, which satisfied our predefined search criteria (Tables 1 and 2) [8][9][10][11][12][13][14][15][16]. Four studies (n = 209) discharged patients on the same day as surgery (group 1) [8][9][10][11], and five studies (n = 293) discharged patients after an overnight stay (group 2) [12][13][14][15][16]. These included three case series, five cohort studies, and one randomised trial.…”

Section: Evidence Synthesismentioning

confidence: 99%

Safety and Efficacy of Day-case Percutaneous Nephrolithotomy: A Systematic Review from European Society of Uro-technology

Jones

Bennett

Dosis

et al. 2019

European Urology Focus

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Analysis of the Feasibility and Efficacy of Ambulatory/Day Care Percutaneous Nephrolithotomy: An Initial Experience

Cited by 3 publications

References 18 publications

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

Day care PNL using 'Santosh-PGI hemostatic seal' versus standard PNL: A randomized controlled study

Safety and Efficacy of Day-case Percutaneous Nephrolithotomy: A Systematic Review from European Society of Uro-technology

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