Tubeless Procedure is Most Important Factor in Reducing Length of Hospitalization After Percutaneous Nephrolithotomy: Results of Univariable and Multivariable Models

Akman, Tolga; Binbay, Murat; Yürük, Emrah; Sarı, Esin Söğütlü; Seyrek, Mahir; Kaba, Mehmet; Berberoğlu, Y.; Müslümanoğlu, Ahmet Yaser

doi:10.1016/j.urology.2010.06.060

Cited by 58 publications

(44 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Others have reported that factors influencing hospital stay included stone burden, number of access and tubeless PCNL, of them tubeless PCNL was the most significant factor (26). In our study, we concluded that a tubeless PCNL impacted hospital stay, pain scores and narcotic requirements, with preoperative narcotic usage being the only additional variable impacting narcotic use.…”

Section: Discussionsupporting

confidence: 49%

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

et al. 2014

View full text Add to dashboard Cite

ARTICLE INFO ______________________________________________________________ ______________________Introduction: Tubeless PCNL has been utilized to shorten hospital stay and improve patient postoperative pain control. Prior studies have excluded those patients with significant bleeding or other complications. Our objective was to evaluate the utility of tubeless PCNL in all patients irrespective of intraoperative outcome. Materials and Methods:A retrospective review of the charts of patients who underwent PCNL at our institute was performed. Patients were assigned to one endourologist who routinely performed tubeless PCNL and to a second endourologist who routinely left a small-bore pigtail nephrostomy. Preoperative demographics operative and postoperative outcomes were compared. Results: Out of 159 patients included, 83 patients had tubeless PCNL while 76 patients had standard PCNL. There was no difference between groups regarding age, gender, ASA score, number, maximum diameter of stones, number of calyces involved, stone density (HU), laterality and use of preoperative narcotics. While staghorn stones were more common in patients who underwent standard PCNL (p = 0.008). Tubeless patients had less number of access tracts (p ≤ 0.001), shorter hospital stay (1.7 vs. 3.0 days, p = 0.001) when compared to standard PCNL group. Multivariable analysis controlling for confounding factors including staghorn calculi and number of accesses confirmed that tubeless PCNL was associated with shorter hospital stay and less postoperative pain. There was no significant difference in complication rates between the two groups. Conclusion: Our report confirms the previous reports of shorter hospital stay, less pain and analgesia as compared to standard PCNL, and establishes its safety irrespective of bleeding, perforation, extravasation or other intraoperative issues that have previously been utilized as exclusionary criteria for this approach.

show abstract

Section: Discussionsupporting

confidence: 49%

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Similar to another study, we found that hospital stay was not affected by hypertension history. [30] Our results showed that lower hemoglobin before surgery is a predictive factor for prolonging hospital stay. Since in a study low hemoglobin before surgery was a predictor of blood transfusion requirement in the first 48 hours after the surgery, [22] the necessity for transfusion could prolong the hospital stay period.…”

Section: Discussionmentioning

confidence: 50%

“…However, Olbert et al [28] found no relationship between hospital stay period and urinary tract infection history based on the univariate and multivariate analysis outcomes. Hydronephrosis grade was not correlated with hospital stay according to Akman et al [30] study using univariate and multivariate analysis. Our different results in hospital stay can be because of various factors which could affect the physicians' decision in choosing the proper treatment approach (inpatient, outpatient or referring patients to other therapeutic medical services).…”

Section: Discussionmentioning

confidence: 80%

Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones

Falahatkar

Mokhtari

Amin

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: This study compared the stone opacity effect in patients who had radiopaque and radiolucent stones in percutaneous nephrolithotomy (PCNL) results. Material and methods:The medical records of 171 complete supine PCNL procedures were gathered. Patients were categorized into two groups: those with radiopaque (n=141) and those with radiolucent (n=30) stones. Kidney, ureter and bladder x-ray was done a day after PCNL and Ultrasound imaging was done two weeks later to evaluate the stone free rate. A stone free result was defined as having less than 4 mm residual stone size. Outcome parameters were compared by univariate analysis and those which were significantly different between the two groups were assessed by multivariate binary logistic regression analysis.Results: There were no significant differences in age, sex, body mass index, hypertension, diabetes mellitus, pre-surgery hemoglobin, pre-surgery serum creatinine, stone and also surgery-related parameters between the two groups. Stone free rate, surgery time, complication-related parameters, hemoglobin drop, serum creatinine and glomerular filtration rate (GFR) changes were similar in both groups based on univariate analysis. The radiopaque group had higher post-surgery GFR (p= 0.04) and longer hospital stay (p= 0.009). However, opacity had no effect on these outcomes after multivariate analysis. Higher post-surgery GFR was seen in patient with higher GFR before surgery (p<0.0001). Also, higher hemoglobin before surgery was correlated with less hospital stay (p= 0.001). Conclusion:The complete supine percutaneous nephrolithotomy outcomes are similar in patients with radiopaque and radiolucent stones.

show abstract

“…This work was accepted and presented at the 30th World Congress of Endourology and SWL, Istanbul, Turkey on September [4][5][6][7][8] 2012. No authors have any conflicts of interest, financial or otherwise.…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…: þ82-2-2228-2320; Mobile: þ82-10-7338-2320; Fax: þ82-2-312-2538; E-mail: KSCHO99@YUHS.AC Recently, the need for placement of a nephrostomy catheter has been questioned due to an increase in postoperative discomfort, low incidence of second-look operation, and increase in morbidity. 6,7 Tubeless PCNL has been attempted with proper drainage of urine through an indwelling anterograde stent instead of a nephrostomy tube, or alternatively without an internal stent at all. 8 Tubeless PCNL is not yet widespread despite the potential benefits of this approach, because there has been a concern for potentially fatal complications such as massive bleeding without a nephrostomy tube.…”

mentioning

confidence: 99%

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Lee

Kim

et al. 2014

International Surgery

View full text Add to dashboard Cite

This study was conducted to report our experience of intraoperative patient selection for tubeless percutaneous nephrolithotomy (PCNL) based on a tentative decision-making algorithm. Thirty-four consecutive patients who were scheduled to undergo tubeless PCNL were included and medical records were obtained from a prospectively maintained database for these patients. After completion of PCNL, the nephrostomy site was observed with a safety guidewire in place. If there was no significant bleeding through the tract, tubeless PCNL was performed, and in cases with significant bleeding or other complications, nephrostomy catheter insertion was performed as usual. In 29 cases (85.3%), tubeless PCNL was performed according to our decision-making protocol. Mean stone size was 7.33 6 9.35 cm 2 . Mean hospital stay was 2.61 6 1.01 days. The difference between preoperative and postoperative hemoglobin was 0.68 6 1.22 g/dL (p . 0.05). Visual analog pain scale scores immediately post-operation, on postoperative day one and on the day of discharge were 4.62 6 1.80, 3.25 6 1.68 (postoperative day one vs. operative day; p ¼ 0.001), and 1.87 6 0.83 (the day of discharge vs. operative day; p ¼ 0.001), respectively. The success rate with insignificant remnant stones was 85.2% and complete stone-free rate was 76.5%. In conclusion, tubeless PCNL was performed successfully with low complication rate and reduced pain score through our decision-making algorithm.

show abstract

Tubeless Procedure is Most Important Factor in Reducing Length of Hospitalization After Percutaneous Nephrolithotomy: Results of Univariable and Multivariable Models

Cited by 58 publications

References 29 publications

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

Tubeless percutaneous nephrolithotomy: outcomes with expanded indications

Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Contact Info

Product

Resources

About