Tube vs Tubeless PCNL: A Comparative Review of Efficacy, Safety and Post-Operative Outcomes
Keywords:
Tubeless PCNL, renal calculi, nephrostomy tube, NephrolithotomyAbstract
Background: Percutaneous nephrolithotomy (PCNL) is the standard treatment for large and complex kidney stones. Traditionally, placing a nephrostomy tube at the end of PCNL has been seen as necessary for drainage, controlling bleeding, and allowing access for follow-up procedures. However, tubeless PCNL, which does not involve placing a nephrostomy tube, has become a less invasive option intended to lower postoperative pain, complications, and hospital stays. The above study was conducted to compare the efficacy, safety and post-operative outcomes in Tube vs. Tubeless PCNL. Methodology-The study was conducted at a tertiary care hospital which included 100 patients undergoing PCNL, who were selected based on the inclusion and exclusion criteria.Based on postoperative drainage, patients were divided into Tube PCNL and Tubeless PCNL groups. Data was collected and analyzed for perioperative and postoperative outcomes using the statistical tests.Results- Mean operative time was significantly higher in the Tube PCNL group (36.6 ± SD)compared to the Tubeless PCNL group (29.0 ± 9.8 minutes; p=0.036).There was no statistically significant difference between Tube and Tubeless PCNL with respect to postoperative hematuria, blood transfusion requirement, UTI, or fever.Conclusion-Tubeless PCNL is a safe and effective option compared to traditional tube PCNL for certain patients. It provides better comfort after surgery and allows for quicker recovery without sacrificing the success of the procedure
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References
[1] Ghani KR, Andonian S, Bultitude M, et al. Percutaneous nephrolithotomy: update, trends, and future directions. Eur Urol. 2016;70(2):382-96.
[2] Knoll T, Buchholz N, Wendt-Nordahl G. Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones. Eur Urol. 2017;71(4):614-7.
[3] Bozzini G, Verze P, Dal Piaz O, et al. Ultrasound-guided access for percutaneous nephrolithotomy: a modern approach. World J Urol. 2020;38(2):353-8.
[4] Xun Y, Wang Q, Hu H, Lu Y, Zhang J, Qin B, et al. Tubeless versus standard percutaneous nephrolithotomy: an update meta-analysis. BMC Urol. 2017 Nov 13;17:102. doi:10.1186/s12894-017-0295-2.
[5] Wang J, Zhao C, Zhang C, Fan X, Lin Y, Jiang Q, et al. Tubeless vs standard percutaneous nephrolithotomy: a meta-analysis. BJU Int. 2012;109:918–24. doi:10.1111/j.1464-410X.2011.10463.x.
[6] Hao Y, Shen X, Han D, Hao Z, Chen D. Tubeless PCNL versus standard PCNL for the treatment of upper urinary tract stones: a propensity score matching analysis. IntUrolNephrol. 2024 Apr;56(4):1281–1288. doi:10.1007/s11255-023-03872-y.
[7] Tomer N, Durbhakula V, Gupta K, Khargi R, Gallante B, Atallah WM, Gupta M. Is Totally Tubeless Percutaneous Nephrolithotomy a Safe and Efficacious Option for Complex Stone Disease? J Clin Med. 2024 May 31;13(11):3261. doi:10.3390/jcm13113261.
[8] Ghoneima W, Makki M, Lotfi MA, Mostafa A, Elkady A, Rammah AM. The feasibility and safety of one-shot dilatation compared to conventional sequential dilatation in tubeless percutaneous nephrolithotomy: a prospective randomized controlled study. Urolithiasis. 2022 Dec 1;51(1):3. doi:10.1007/s00240-022-01383-6.
[9] Mousavi-Bahar SH, Mehrabi S, Moslemi M. The safety and efficacy of PCNL with supracostal approach in the treatment of renal stones. IntUrolNephrol. 2011;43(4):983–7.
[10] Shalaby M, Abdalla M, Aboul-Ella H, et al. Single puncture percutaneous nephrolithotomy for management of complex renal stones. BMC Res Notes. 2009;2:62.
[11] Singh R, Kankalia S, Sabale V, et al. Comparative evaluation of upper versus lower calyceal approach in percutaneous nephrolithotomy for managing complex renal calculi. Urol Ann. 2015;7(1):31–5.
[12] Amaresh M, Hegde P, Chawla A.et al. Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi. World J Urol. 2020;39(7):2155–61.
[13] Yong-bi L. Experience of treatment of 200 cases of upper urinary tract calculi with min-PCNL. Hainan Med J. 2014.
[14] Nawaz A, Shah S, Sohail M, et al. Comparative evaluation of upper and non-upper pole punctures in PCNL. J Health Rehabil Res. 2024;4(1):950-4.
[15] Mazumder MKU, Haque MMU, Nandy SP, et al. Quasi-experimental comparison of upper and lower calyceal access in percutaneous nephrolithotomy for complex renal calculi in Bangladesh. IAHS Med J. 2023;6(1):62–67.
[16] Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 2004;18(8):715–722.
[17] Aron M, Yadav R, Goel R, Kolla SB, Gautam G, Hemal AK. Multi-tract percutaneous nephrolithotomy for large renal calculi: feasibility, safety and efficacy. J Endourol. 2005;19(8):1009–1014.
[18] Shrestha PM, Kunwar AK. The safety and efficacy of supracostal punctures in PCNL. Postgrad Med J NAMS. 2015;15(2):120–7.
[19] El-Karamany T. A supracostal approach for percutaneous nephrolithotomy of staghorn calculi: a prospective study and review of previous reports. Arab J Urol. 2012;10(4):358–66..
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