Tubeless and stentless percutaneous nephrolithotomy

Gupta, Vikas; Sadasukhi, Trilok Chand; Sharma, Krishan Kumar; Yadav, Ram Gopal; Mathur, Rajendra Mohan

doi:10.1111/j.1464-410x.2005.05432.x

Cited by 43 publications

(25 citation statements)

References 13 publications

(11 reference statements)

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“…Study results of Agrawal et al [16] are in contrast to our results where we reported no difference between both PCNL techniques in terms of analgesic requirements, hospital stay, and urinary leakage (p>0.05). Gupta et al [17] reported successful and cost-effective management of renal stones by applying PCNL without using ureteric stents. Karami et al [18] also documented that PCNL performed without nephrostomy tubes has positive impact on decreasing the duration of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study

Iqbal¹,

Assad²,

Hussain³

et al. 2018

Turkish Journal of Urology

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Objective: To evaluate and compare the effectiveness of tubeless percutaneous nephrolithotomy (PCNL) and tubed PCNL by using small bore nephrostomy tube (12Fr) in children for the management of nephrolithiasis. Material and methods:This study was a retrospective analysis of 35 children where tubed PCNL (Group 1) was done in 18, and tubeless PCNL (group 2) in 17 patients from January 2010 to December 2016. Charts were reviewed for age, mass, stone size, operative time, hospital stay and stone-free rates.These variables were compared between the two groups. SPSS version 21 was used for data analysis. The data were shown as mean±standard deviation for continuous variables.Categorical variables were presented in percentages.Results: There is no difference in terms of age, stone sizes, operative times, hospital stays, stone-free rates and post-PCNL complications between the two groups (p>0.05). The mean drop in hemoglobin level was 0.7±0.1 g/dL and 1.3±0.2 g/dL in Groups 1 and 2, respectively (p= 0.01). Conclusion:Tubeless PCNL in children is a safe option in well selected cases.

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Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study

Iqbal¹,

Assad²,

Hussain³

et al. 2018

Turkish Journal of Urology

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“…15 There have been significant advances in the percutaneous extraction of renal calculi. [2][3][4][5][6][7][8][9][10] Review articles have highlighted the need for minimal intra-operative bleeding, negligible residual stone burden, and one to two attempts at renal access when considering tubeless approaches. Recently, the ability to perform tubeless PCNL as an outpatient procedure has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Since its description in the 1970s, 1 surgical and technological advances have obviated the need for routine nephrostomy tube placement. [2][3][4][5][6][7][8] Tubeless PCNL, with ureteral stenting, has been shown to decrease patients' analgesic requirements and hospital length of stay. 9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management.…”

Section: Introductionmentioning

confidence: 99%

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

McAlpine

Leveridge

Beiko

2015

CUAJ

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Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney. IntroductionPercutaneous nephrolithotomy (PCNL) is an accepted and widely used approach to extract large renal calculi. Since its description in the 1970s, 1 surgical and technological advances have obviated the need for routine nephrostomy tube placement.2-8 Tubeless PCNL, with ureteral stenting, has been shown to decrease patients' analgesic requirements and hospital length of stay.9,10 Although hospitalization is standard practice after PCNL, reports have described success with outpatient management. 11,12 This case report is the first to describe successful outpatient PCNL in a renal transplant patient. Case reportA 49-year-old female presented to her community hospital with hematuria and lower abdominal pain over the preceding 48 hours. She had received her second cadaveric kidney transplant 6 years previously for end-stage renal disease of unknown etiology. On presentation she was afebrile and hemodynamically stable. Urine was positive for blood, but negative for nitrites or pyuria. Creatinine was 164 μmol/L (estimated glomular filtration rate 29 mL/min/1.73m 2 ), slightly elevated from her baseline of 150 μmol/L. An ultrasound scan showed a large renal stone in the lower pole of the allograft kidney. Intravenous antibiotics were initiated and the patient was transferred to our tertiary care centre.At our institution, a computed tomography scan revealed a 14 × 12 × 11-mm stone located in the renal pelvis (Fig. 1a, Fig. 1b). There was mild hydronephrosis, yet the parenchyma of the graft was preserved. There was no evidence of a urinary tract infection (UTI)/sepsis and the patient's pain responded to oral analgesia. The surgical options were discussed and a decision was made to proceed with the PCNL. Informed consent was obtained and a 1-week course of levofloxacin was prescribed for UTI prophylaxis.On the morning of the procedure, a stress dose of 100 mg intravenous (IV) hydrocortisone was administered. Cefazolin 1 g IV was given prior to induction of general anesthesia. Flexible cystourethroscopy was performed and a 5Fr openended ureteral catheter was passed up the left transplanted ureteral orifice over a 0.035" guidewire. A Foley catheter was placed to straight drainage and the patient was repositioned supine for percutaneous access. Retrograde ureteropyelography outlined the allograft kidney's collecting system, demonstrating renal...

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“…[10][11][12] Totally tubeless PCNL avoids the use of nephrostomy tubes and ureteral stents, and relies upon ureteral peristalsis for kidney drainage. Crook and colleagues recommend this technique in patients with no or minimal residual stone burden and cautions against the totally tubeless approach in patients requiring upper renal access or patients with horseshoe kidneys.…”

Section: Cuaj • August 2010 • Volume 4 Issue 4 E88mentioning

confidence: 99%

Outpatient tubeless percutaneous nephrolithotomy:the initial case series

Beiko

Lee

2013

CUAJ

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Introduction: Percutaneous nephrolithotomy (PCNL) has traditionally been performed on an inpatient basis. To the best of our knowledge, this is the first report of tubeless PCNL on a completely outpatient basis. The purposes of this study were to assess the safety and efficacy of outpatient PCNL. Methods: We reviewed the initial consecutive outpatient tubeless PCNLs performed at our institution by a single surgeon. Patients were discharged home the day of surgery only after meeting strict discharge criteria. Preoperative, intraoperative and postoperative data were collected prospectively. Results: Outpatient tubeless PCNL was performed in 3 patients. The mean maximum stone diameter was 14 mm. The average hospital stay was 175 minutes. All 3 patients were discharged home in stable condition after meeting all of the inclusion criteria. There were no emergency room visits or hospital readmissions postoperatively. The mean follow-up period was 47 days. All stones were calcium oxalate and the stone free rate was 100%. There were no minor or major complications. Conclusion: In properly selected patients, outpatient tubeless PCNL is safe and effective. Our initial experience with outpatient PCNL has been favourable and warrants further investigation in a larger patient population.Can Urol Assoc J 2010;4(4):E86-90

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Tubeless and stentless percutaneous nephrolithotomy

Cited by 43 publications

References 13 publications

Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study

Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study

Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

Outpatient tubeless percutaneous nephrolithotomy:the initial case series

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