No Panacea for Drainage after Percutaneous Nephrolithotomy

Marcovich, Robert; Jacobson, Avrum; Singh, Jaspreet; Shah, Darshan H; El-Hakim, Assaad; Lee, B.R.; Smith, Arthur D.

doi:10.1089/end.2004.18.743

Cited by 47 publications

(20 citation statements)

References 11 publications

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“…However, the tube itself may be associated with increased morbidity [5,6]. Recent randomized studies have shown that, avoiding external nephrostomy tube drainage, termed as the 'tubeless PNL' procedure, significantly decreased pain and morbidity of PNL, and diminished related expenses in selected patients [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

et al. 2006

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Section: Introductionmentioning

confidence: 99%

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

et al. 2006

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“…Of 24 studies in this review, 20 made comparisons between the overall duration of procedure [2,3,4,5,6,7,8,9,12,13,14,18,19,20,22,23,24,25,26,27]. In 13 studies [2,4,7,8,9,14,18,19,22,24,25,26,27] the procedure was shorter when tubeless.…”

Section: Resultsmentioning

confidence: 99%

“…In 13 studies [2,4,7,8,9,14,18,19,22,24,25,26,27] the procedure was shorter when tubeless. This was statistically significant for only 1 study [4].…”

Section: Resultsmentioning

confidence: 99%

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Standard versus Tubeless Percutaneous Nephrolithotomy: A Systematic Review

Amer¹,

Ahmed²,

Bultitude³

et al. 2012

Urol Int

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Objective: This article systematically analyses comparative studies to evaluate the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL) versus standard PCNL. Methods: The Medline, EMBASE, PsycINFO, Cochrane and DARE databases were searched from 1997 to February 2011. Comparative studies evaluating outcomes from standard versus tubeless PCNL were included. Primary outcome measures were post-operative pain scoring, analgesic requirements, duration of hospitalisation/convalescence, operation time, major/minor complications and stone-free rates. Results: Twenty-four studies were included (11 randomised control trials and 13 retrospective or prospective studies). Levels of pain recorded, analgesic requirements, duration of inpatient stay and convalescence time were all significantly reduced in the tubeless PCNL group. Cost was reduced in two studies. Morbidity was not significantly different between the groups. There was no significant difference between groups regarding stone-free status. Discussion: This systematic review has demonstrated that tubeless PCNL is a viable alternative to tubed PCNL in uncomplicated cases. Benefits are as described above. There is no evidence suggesting that patient safety is compromised by the absence of post-operative nephrostomy. The tubeless method has been reported in challenging cases such as stag-horn stones, horseshoe or ectopic kidneys. Promising outcomes have been demonstrated in elderly patients and when clinical needs demand a supracostal approach. Multi-centre randomised controlled trials are needed to fully establish the effectiveness of the tubeless method.

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“…Analysis of the literature shows that a smaller-calibre tube (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Fr) has been associated with less pain and less urinary leakage compared to larger tubes. [51][52][53][54][55][56] Importantly, there is no further advantage in pain levels to opting for a tubeless approach (i.e., internal ureteral stent) compared to a small-calibre external tube. A 2012 meta-analysis of studies comparing tubes of differing sizes and tubeless approaches concluded that the clinical efficacy and safety of tubeless and small-tube procedures are similar.…”

Section: Laparoscopy and Minimally Invasive Surgery 2014mentioning

confidence: 99%

Highlights of the University of Toronto Urology Update 2014

Herschorn

2015

CUAJ

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At the University of Toronto Urology Update 2014, a faculty of Canadian and American experts presented a series of lectures covering a range of topics in the field of urology. Areas of focus included prostate cancer (PCa), functional urology, erectile dysfunction (ED), and surgical topics (e.g., percutaneous nephrolithotomy [PCNL]). Prostate cancer screening in 2014: The debate rages on Highlights of presentations by Drs. Neil Fleshner, Girish Kulkarni, Anthony Miller and H. Ballentine CarterThe utility of the serum prostate-specific antigen (PSA) test for the early detection of PCa has been the subject of vigorous debate among clinicians, researchers and policy-makers. As discussed at Urology Update 2014, authors of current and recent guidelines still do not agree on whether or not screening should be offered on a population basis.

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No Panacea for Drainage after Percutaneous Nephrolithotomy

Abstract: This study did not demonstrate an overwhelming advantage of any one drainage system over the others. All three systems were equally tolerated by patients. There may be less chance of prolonged nephrostomy-site leakage with an 8F pigtail catheter.

Cited by 47 publications

References 11 publications

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison

Standard versus Tubeless Percutaneous Nephrolithotomy: A Systematic Review

Highlights of the University of Toronto Urology Update 2014

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