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 Comparison of tubeless versus tubed percutaneous nephrolithotomy

2018 ◽  
Vol 8 (1) ◽  
pp. 24-31
Author(s):  
Rajiv Shah ◽  
Nirmal Lamichhane ◽  
Sudeep Raj K.C.
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
P Value ◽  
Transfusion Rate ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Tubeless Pcnl ◽  
Post Operative Complications

Percutaneous nephrolithotomy (PCNL) is an effective treatment for large renal calculi and usually a nephrostomy tube is placed in the kidney at the end of procedure to avoid post operative complications. This is to compare the outcome of tubeless PCNL versus tubed PCNL. In a randomized prospective study of sixty-four consecutive patients were enrolled and divided into two groups; A being tubeless group and B being nephrostomy group with 32 patients in each arm divided by quota sampling restricted block method with allocation ratio of 1:1. The mean age in group A was 36.69 ± 13.65 years and in group B was 38.09 ± 13.18 years with no significant p value (p = 0.501). Duration of hospital stay in group A was 3.63 ± 1.04 days and in group B was 6.34 ± 1.71 days with a significant p value (p = 0.001). In group A 31 (96.9%) and in group B 24 (75%) cases were not transfused with blood while 1 (3.1%) and 8 (25%) cases were transfused with blood with a significant p value (p = 0.026). The post operative complications were comparable in between two groups. Therefore tubeless PCNL reduces the hospital stay and blood transfusion rate with no obvious post operative complications.

scholarly journals Comparison of standard and tubeless percutaneous nephrolithotomy for renal calculi: a prospective randomized control trial

2019 ◽  
Vol 6 (4) ◽  
pp. 185
Author(s):  
Manu Muraleedharan Kamalakshi ◽  
Vasantharaja Ramasamy ◽  
Darsan Sadasivan ◽  
Sunil Raveendran ◽  
Selvam Paramasivam ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Randomized Control Trial ◽  
Renal Stones ◽  
Renal Calculi ◽  
Analgesic Requirement ◽  
Operative Duration ◽  
Significant Difference ◽  
Randomized Control ◽  
Tubeless Pcnl

<p class="abstract"><strong>Background:</strong> In the current era of minimally invasive interventions, the mainstay of treatment of renal stones larger than 2 cm is Percutaneous nephrolithotomy (PCNL). PCNL underwent various evolutionary changes minimizing morbidity to the patients. We prospectively compared the outcome of tubeless PCNL (without nephrostomy drainage tube) to reduce the pain and discomfort caused by tube with standard PCNL in the treatment of renal stones.</p><p class="abstract"><strong>Methods:</strong> In this Randomized control trial (RCT), we divided patients satisfying the inclusion criteria of consenting for trial, single access puncture, less than 3 stones each less than 3 cm, operative duration of less than 2 hours into two groups, standard PCNL (group 1) and tubeless PCNL (group 2) with 25 patients each. Randomization and group assignment were done after complete clearance of renal stones.</p><p class="abstract"><strong>Results:</strong> Patient’s age, gender, sides of stone and stone size were comparable between two groups (standard versus tubeless PCNL). Postoperative hemoglobin drop, bleeding, pyrexia, urine leak, and blood transfusion requirement did not show a statistically significant difference between the two groups. Analgesic requirement (190 mg versus 80 mg of tramadol), operative duration (49.80 min versus 38.60 min), postoperative pain score (6/10 versus 3.64/10-visual analog scale) and duration of hospital stay (68.48 hours versus 41.12 hours) showed statistically significant difference favoring tubeless PCNL.</p><p class="abstract"><strong>Conclusions: </strong>Tubeless PCNL may be a safe, acceptable and effective modality of treatment for renal calculi in carefully selected patients comparing standard PCNL resulting in less operative duration, lower postoperative pain, reduced analgesic requirement and shorter hospital stay.</p>

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

2015 ◽  
Vol 9 (5-6) ◽  
pp. 324 ◽  
Author(s):  
Kristen McAlpine ◽  
Michael J. Leveridge ◽  
Darren Beiko
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Stable Condition ◽  
Renal Calculi ◽  
Renal Allografts ◽  
Transplanted Kidney ◽  
First Case ◽  
Successful Case ◽  
Tubeless Pcnl

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.

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 PERCUTANEOUS NEPHROLITHOTOMY

2011 ◽  
Vol 18 (04) ◽  
pp. 575-580
Author(s):  
IMRAN HUSAIN ◽  
MUHAMMAD MUZAMMIL TAHIR ◽  
SHAHZAD ASHRAF ◽  
Muhammad Usman Khan
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Outcome ◽  
Nephrostomy Tube ◽  
Group Iii ◽  
Group I ◽  
Analgesia Requirement ◽  
Group Ii ◽  
Tubeless Pcnl ◽  
Group 1

Purpose: We compared postoperative outcome of conventional large bore percutaneous nephrolithotomy (PCNL) with small bore and tubeless percutaneous ephrolithotomy (PCNL). Study Design: prospective randomized trial. Period: August 2008-2009 Setting: Shaikh Zayed Hospital Lahore. Materials and Methods: The study included 90 patients randomized in three groups. Group. 1 included 30 patients who underwent conventional PCNL with large bore 16 fr nephrostomy tube, Group2 included 30 patients, PCNL with small bore 10 fr nephrostomy tube, and Group3 included 30 patients who had tubeless PCNL. Comparison was made in the terms of analgesia requirement, fever, duration of urinary leak and hospital stay. Results: In Group 1 analgesia requirement ranged from 40-70mg mean 50mg, in Group II, it was 30-60mg with mean 47.3mg while in Group III, The requirement of analgesia was 10-50mg with mean 21.1mg, p<0.005. Hospital stay was between 4 to 7days, mean 5.7days in group I while in group II, stay was between 3 to 5 days, mean 4.3days and in group III, it was between 1 to 4 days, mean 3.17days, p <0.005. Twelve patients had fever in group I, In group II, eleven patients while in group III, five patients developed fever, p <0.005. Leakage of urine from site of wound in group I was observed between 0 to 5 days while in group II leakage was between 0 to 4 days, and the leakage period reduced in group III from 0 to 2 days p <0.005. Conclusions: Tubeless PCNL is associated with the least postoperative pain. urinary leakage, fever and hospital stay, it’s a good option after an uncomplicated percutaneous renal procedure 

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.

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 &gt; 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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