scholarly journals Outpatient tubeless percutaneous nephrolithotomy and concomitant cystolitholapaxy

2014 ◽  
Vol 8 (3-4) ◽  
pp. 179
Author(s):  
Kyle J Lehmann ◽  
Darren Beiko
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Healthcare Costs ◽  
Outpatient Surgery ◽  
Renal Stones ◽  
Outpatient Basis ◽  
Tubeless Pcnl ◽  
Tubeless Percutaneous Nephrolithotomy ◽  
Inpatient Basis

Percutaneous nephrolithotomy (PCNL) is a widely employed endourologic procedure to remove renal stones. Traditionally, PCNL has been performed on an inpatient basis, with patients routinely hospitalized postoperatively. Given the ongoing rising healthcare costs, a shift toward outpatient surgery is desirable. We report the case of a 21-year-old female who was safely discharged a few hours following uncomplicated tubeless PCNL and concomitant cystolitholapaxy for a stent with encrustation on its distal coil. To the best of our knowledge, this is the first published case of tubeless PCNL with concomitant cystolitholapaxy performed on an entirely outpatient basis.

Tubeless Percutaneous Nephrolithotomy with Hemostatic Plug Using Surgiflo® versus Standard Percutaneous Nephrolithotomy using a Nephrostomy Tube: A Prospective Randomized Controlled Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hisham Mohamed Fathey Elshawaf ◽  
Mohamed Ismail Shabayek ◽  
Mohamed Ahmed Saleh Ahmed
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Intraoperative Complications ◽  
Demographic Data ◽  
Renal Stones ◽  
Controlled Study ◽  
P Value ◽  
Nephrostomy Tube ◽  
Gelatin Matrix ◽  
Significant Difference ◽  
Tubeless Pcnl

Abstract Background Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large renal stones (over 2cm in diameter). It involves keyhole surgery performed through a small skin incision overlying the kidney. Objectives Our study aimed at evaluating the safety and efficacy of local hemostatic sealant (surgiflo®) use in tubeless PCNL to enhance postoperative outcomes of PCNL. Patients and Methods We randomized our patients into two groups, Group A nephrostomy tube was used as standard PCNL, and at group B tubeless PCNL was done followed by injection of the local hemostatic flowable gelatin matrix (surgiflo®) under fluoroscopic guidance in the prone position Results There was no statistically significant difference between two groups regarding demographic data age, sex and BMI (P- value 0.280, 0.736 and 0.440 respectively), stone site and size (P- value 0.525 and 0.533 respectively), operative time (P- value 0.855), intraoperative complications as blood loss and pelvicalyceal perforation, (P- value 0.92 and P- value 0.83 respectively), postoperative complication as fever, haematuria and UTI (P- value 1.000, 0,113 and 1.000 respectivly), and Hb drop (P- value 0.735). Conclusion Tubeless PCNL with hemostatic sealant use is associated with less pain, no leakage from nephrostomy tract, less narcotic agent use, and a shorter hospital stay.

scholarly journals Simultaneous bilateral tubeless percutaneous nephrolithotomy:

2013 ◽  
Vol 6 (4) ◽  
pp. 162 ◽  
Author(s):  
Alice Yu ◽  
Walid Shahrour ◽  
Sero Andonian
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Lower Cost ◽  
Renal Calculi ◽  
Remote Areas ◽  
Tubeless Pcnl ◽  
Tubeless Percutaneous Nephrolithotomy ◽  
Postoperative Discomfort

Percutaneous nephrolithotomy (PCNL) is currently the standardof care to remove large renal calculi. Traditionally, a large-borenephrostomy tube is placed postoperatively. However, the necessityof this practice has been recently challenged. Theoretically, bilateral tubeless PCNL offers advantages of lower postoperative discomfort, shorter hospital stay and thus lower cost. We review the literature and present two cases of simultaneous bilateral tubeless PCNL from two patients who were referred to a tertiary stone centre from remote areas.

scholarly journals Tubeless Percutaneous Nephrolithotomy: Can be a Choice, Why Not?

2014 ◽  
Vol 7 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Aslan Demir ◽  
Ramazan Kocaaslan ◽  
Kerem Taken ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Drainage System ◽  
Standard Of Care ◽  
Renal Stones ◽  
Renal Calculi ◽  
Safe Procedure ◽  
Nephrostomy Tube ◽  
Renal Surgery ◽  
Hemorrhagic Tendency ◽  
Tubeless Pcnl

Percutaneous nephrolithotomy (PCNL) has been widely accepted and is commonly used to treat renal calculi. The optimal drainage of kidney after PCNL has not been clearly determined yet. Placement of an 18F to 24F nephrostomy tube at the end of the procedure is accepted as standard of care to date. The main advantages are adequate renal drainage, hemostatic tamponade and providing renal access for second look PCNL. However, based on the concept that the purpose of the tube is only to maintain adequate drainage of the kidney, a “tubeless” approach has been developed by placing a ureteral stent or catheter to provide drainage after PCNL instead of a nephrostomy tube. Tubeless PCNL is an effective and safe procedure for treatment of renal stones in selected cases. This procedure can even be chosen for patients with previous renal surgery, and hemorrhagic tendency. By using this method, less postoperative pain and a shorter hospital stay can be achieved, when compared with conventional PCNL. There is a controversy over ideal drainage system after PCNL in recent years. Herein, we made a systematic review for efficacy and safety of tubeless PCNL, totally tubeless PCNL, discussed different variations and compared the outcomes of this technique with standart PCNL.

scholarly journals Are Nephrostomy and Ureteral Stent Necessary after Multi-Access Percutaneous Nephrolithotomy?

2019 ◽  
Vol 13 (3) ◽  
pp. 141-144 ◽  
Author(s):  
Seyed Mohammad Kazem Aghamir ◽  
Reza Heidari ◽  
Seyedehsara Bayesh ◽  
Alborz Salavati ◽  
Reza Elmimehr
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Length Of Hospital Stay ◽  
Renal Stones ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Single Access ◽  
Group A ◽  
Group B ◽  
Multi Access ◽  
Tubeless Pcnl

Introduction: Totally tubeless percutaneous nephrolithotomy (PCNL) is a well-established technique used in single -access procedure nevertheless these results challenge the multi-access PCNL as a contra-indication to application of this technique. Aims: To compare complication rates and safety of use of this technique after multi-access PCNL. Methods: A Total of 130 patients with renal stones were enrolled in this cohort study. Totally tubeless PCNL with single access (Group A, n = 70) and multi-access (Group B, n = 60) were done and bleedings were assessed by measuring hemoglobin (Hb) drop, blood transfusion rate and need for angioembolization besides leakage rates which were also recorded. Results: In the 130 patients who underwent totally tubeless PCNL, no leakage from puncture site nor angioembolization cases were identified. There was no significant statistical differences between 2 groups regarding Hb drop (1.91 in single access versus 2.20 in multi-access), transfusion rate and length of hospital stay (p > 0.05). Stone-free rate was increased from 91% in single access to 97% in multi access by adding percutaneous access sites (from 91% in single access to 97% in multi-access). Conclusions: Multi-access totally tubeless PCNL seems feasible and has comparable complication rates including Hb drop besides providing the advantage of higher stone-free rates using multi-access tracts.

scholarly journals Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

2014 ◽  
Vol 99 (5) ◽  
pp. 662-668 ◽  
Author(s):  
Joo Yong Lee ◽  
Kyu Hyun Kim ◽  
Man Deuk Kim ◽  
Doo Yong Chung ◽  
Kang Su Cho
Keyword(s):  
Decision Making ◽  
Percutaneous Nephrolithotomy ◽  
Patient Selection ◽  
Pain Scale ◽  
Scale Scores ◽  
Post Operation ◽  
Selection For ◽  
The Difference ◽  
Tubeless Pcnl ◽  
Tubeless Percutaneous Nephrolithotomy

Abstract 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 ± 9.35 cm2. Mean hospital stay was 2.61 ± 1.01 days. The difference between preoperative and postoperative hemoglobin was 0.68 ± 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 ± 1.80, 3.25 ± 1.68 (postoperative day one vs. operative day; p = 0.001), and 1.87 ± 0.83 (the day of discharge vs. operative day; p = 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.

scholarly journals Outpatient bilateral supracostal tubeless percutaneous nephrolithotomy for staghorn calculi

2014 ◽  
Vol 8 (3-4) ◽  
pp. 273 ◽  
Author(s):  
Andrea Kokorovic ◽  
James William Lennox Wilson ◽  
Darren Beiko
Keyword(s):  
Case Report ◽  
Percutaneous Nephrolithotomy ◽  
Surgical Procedure ◽  
Hospital Costs ◽  
Stable Condition ◽  
Feasible Method ◽  
Staghorn Calculi ◽  
Inpatient Procedure ◽  
Tubeless Pcnl ◽  
Tubeless Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is the surgical procedure of choice to treat staghorn calculi. Most centres perform PCNL as the traditional inpatient procedure. However, outpatient PCNL has been successfully attempted and represents a feasible method of reducing hospital costs. We report the case of a 35-year-old female who underwent outpatient simultaneous PCNL for bilateral renal staghorn calculi. The patient was discharged in stable condition less than 3 hours following the procedure with minimal discomfort. To the best of our knowledge, this case report is the first to describe a successfully completed outpatient bilateral supracostal tubeless PCNL for staghorn calculi.

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