Objective: To study the ability of rendering our patients tube and stent free after percutaneous nephrolithotomy (PNL).
Patients and Methods: Between February 2011 and March 2012, 38 patients (40 units) with 20 to 60 mm (mean: 31.17) renal stones underwent tubeless stentless PNL. The sample consisted of 28 males and 10 females, and their ages ranged between 17 and 65 years (mean: 33.7). Twenty-two cases were in the right kidney while 18 were in the left, and the stones were bilateral in 2. Most of the stones were in the renal pelvis and lower calyx and removed through the lower calyx subcostal with a single puncture. After ensuring that the patient was almost stone free, no nephrostomy was left and the ureteric catheter was removed within 30 minutes.
Results: Operative time ranged between 15 and 80 mins (mean: 42.34) and no blood transfusion was needed. The mean reduction in hemoglobin level was 1.52 gm (range: 0.3 to 4.8) and the hospital stay ranged between 12 to 36 hours (mean: 17.7). The success rate was 100% while the stone free rate was 95%. Analgesia was needed in 20% of cases. There were no intraoperative complications while postoperative complications occurred in 3 patients (9.7%) in the form of leakage, perirenal collection, and secondary hemorrhage.
Conclusion: Tubeless, stentless PNL is safe with acceptable complications, provided patients are stone free with no or minimal extravasations, have acceptable bleeding, and there is a single puncture. It decreases hospital stay, postoperative pain, and the need for analgesia, and subsequently lowered work abstinence. A further study with a larger sample is needed.
Tawfik H. Al- Ba’adani, Qaid Al-Ghashami, Shihab Al Germozi, Salah Ahmed, Shoukry Al Flahi, Ibrahim Al-Nadhari, Gamil Al Alimi, Walid Al Asbahi, Khalid Telha, Ibrahim El-Nono
Urology Department, Urology and Nephrology Center, Thawra Hospital, Sana'a University, Sana'a, Yemen
Submitted May 16, 2013 - Accepted for Publication September 13, 2013
KEYWORDS: Stentless, tubeless, PNL
CORRESPONDENCE: Tawfik H. Al- Ba’adani, Urology Department, Urology and Nephrology Center, Thawra Hospital, Sana'a University, Sana'a, Yemen ()
CITATION: UroToday Int J. 2013 October;6(5):art 57. http://dx.doi.org/10.3834/uij.1944-5784.2013.10.04