Observational prospective study for surgical outcome and anesthetic feasibility of tubeless and totally tubeless supine PCNL: A single centre initial experience

Gupta, Sonam; Maurya, Arun Kuamr; Pal, Dilip Kumar

doi:10.5152/tud.2018.97345

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…Recently, new modifications were described by the miniaturization of instruments as external ureteral catheterization and totally tubeless PCNL. [12][13][14] These modified techniques were safe and effective and further improve patient comfort after the operation. We use this procedure in daily practice but, we did not include this group in our study due to the limited number of cases.…”

Section: Discussionmentioning

confidence: 94%

Retrospective comparison of tubeless and standard percutaneous nephrolithotomy

Korğalı¹,

Ergin²,

Kıraç³

2020

Cumhuriyet Medical Journal

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Comparison of tubeless percutaneous nephrolithotomy (tPCNL) and standard percutaneous nephrolithotomy (sPCNL) performed in renal stone surgeries in terms of patient comfort, post-operative hospitalization time and complications. Method: In our clinic, sPCNL was performed by placing a nephrostomy catheter in 87 patients out of 133 patients, and tPCNL was performed by placing a Double J catheter in 46 patients. Results: There was no statistical difference between the two patient groups in data such as age, gender, stone size, guy's score, stone variable, and side (p>0.05). Also in the perioperative data; operation time, stone-free rates, perioperative hemoglobin decrease, blood transfusion, and statistical difference between the two groups were not found (p>0.05). There was no significant difference between stone groups such as stonelessness rate, postop hemoglobin decrease, operation time and stone properties such as stone size, guy's score, stone variable (p>0.05). Analgesia dose, length of hospitalization, return to activity (p=0.001), fever during post-op period (p=0.016), urine leakage from the nephrostomy tract (p=0.002) were found to be statistically significant lower in the tPCNL group. More tPCNL was performed on the upper pole stones which was found statistically significant (p=0.008). Conclusions: Tubeless PCNL operation is an end urological method that can be applied effectively and safely by experienced surgeons with advantages such as less pain in early postoperative period, shorter hospitalization, returning to physical activity earlier, less fever and less urine leakage than nephrostomy tract.

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Section: Discussionmentioning

confidence: 94%

Retrospective comparison of tubeless and standard percutaneous nephrolithotomy

Korğalı¹,

Ergin²,

Kıraç³

2020

Cumhuriyet Medical Journal

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“…We performed four (20%) tubeless PCNLs, which have the benefit of less postoperative discomfort. Supine and tubeless PCNL offer beneficial effects for both surgeries [ 7 ]. It has been shown that, in carefully selected patients, tubeless PCNL is a safe option [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

An Observational Pilot Study on Supine Percutaneous Nephrolithotomy: Initial Experience at a Single-Centre

Bhardwaj¹,

Sinha²,

Deb³

et al. 2023

Cureus

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To assess the surgical outcome of supine percutaneous nephrolithotomy (PCNL) in patients with comorbidities. Materials and methodsWe retrospectively reviewed the data of 15 patients who underwent supine PCNL at our centre from September 2019 to May 2021. Preoperatively, a complete examination of the patients, along with biochemical and radiological investigations, was done. The data, which included patient demographics, comorbidities, complexity of renal calculi, complications, and stone clearance rate, were collected from the patients' medical records. ResultsPatients aged between 31 and 70 years were included in the study. The mean (SD) BMI was 26.01 (2.31).Twelve patients (80%) were overweight with a BMI of 25.3 to 29.3 kg/m 2 . The most common comorbidities were diabetes (33.3%) and hypertension (26.7%). In our study, six patients were American Society of Anesthesiologists (ASA) grade 3 (40%), followed by grade 2 in five patients (33.3%), grade 4, and grade 1 in two patients (13.3%) each. The Guy's Stone score was one in nine patients (60%) and two in six patients (40%). Complete clearance was achieved in 13 (86.7%) patients. Two patients (13.3%) had a stone clearance of more than 80%. Data analysis showed that 14 patients (93.3%) had no perioperative complications. Postoperative abdominal distension was noted in one patient (6.7%), which was managed conservatively (Clavien-Dindo grade 1). We did not encounter any cases of organ injury following supine PCNL. Postoperatively, none of our patients received blood transfusions. ConclusionOur study shows that supine PCNL is a good surgical option, especially for high-risk patients with good stone clearance and low complication rates.

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“…18 The low rate of complications in our cohort support the safety of POD1 stent removal and consideration of more study and/or more widespread adoption, particularly considering the similar success rates of totally tubeless approaches. 4,19 A short-term indwelling stent over a "totally tubeless" approach has some potential advantages. Stenting with a Foley allows renal decompression after this procedure and provides for the rapid identification of patients with severe bleeding that may need additional procedures.…”

Section: Discussionmentioning

confidence: 99%

POD1 Stent Removal after PCNL

Mershon

Goodstein

Khuhro

et al. 2023

Journal of Endoluminal Endourology

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Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard for treating large or complex renal stones. Renal drainage after the procedure is most commonly via nephrostomy tube or indwelling ureteral stent, but the optimal duration of ureteral stents after PCNL is currently unknown. This study describes the post-operative events occurring with early stent removal on post-operative day one (POD1) in patients undergoing uncomplicated PCNL. Methods: We identified 336 patients from a single institution that underwent PCNL between 1/1/2020 and 6/1/2021. Of these, 106 patients with uncomplicated procedures that met inclusion criteria for early stent removal on POD1 were included. Retrospective chart review was performed to collect demographic information, operative data, and to identify adverse outcomes including additional procedures, patient telephone calls for symptoms, complications and emergency department (ED) visits. Results: Mean (SD) patient age was 54 (15.1) years and 56% of patients were morbidly obese (Body Mass Index [BMI] >30). Overall post-operative complication rate was low (18.8%) and limited primarily to Clavien I/II complications with only two Clavien III (1.9%) complications. Telephone calls or electronic messages were received from 37.7% of patients, with 16% requiring a visit to the ED or clinic. The most common reason for an ED visit was flank pain (11.1%). Conclusions: Early stent removal on POD1 may lead to pain-related telephone calls but appears to be a generally safe and effective management option in carefully selected patients undergoing uncomplicated PCNL.

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Observational prospective study for surgical outcome and anesthetic feasibility of tubeless and totally tubeless supine PCNL: A single centre initial experience

Cited by 9 publications

References 24 publications

Retrospective comparison of tubeless and standard percutaneous nephrolithotomy

Retrospective comparison of tubeless and standard percutaneous nephrolithotomy

An Observational Pilot Study on Supine Percutaneous Nephrolithotomy: Initial Experience at a Single-Centre

POD1 Stent Removal after PCNL

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