Is nephrostomy tube a rule following all Percutaneous Nephrolithotomy (PCNL)?

A prospective randomized study

  • Pawan Raj Chalise Department of Urology and Kidney Transplant SurgeryInstitute of MedicineTribhuvan University Teaching Hospital
  • Bhoj Raj Luitel Department of Urology and Kidney Transplant Surgery, TU Teaching Hospital, Institute of Medicine, Tribhuvan University
  • Suman Chapagain Department of Urology and Kidney Transplant Surgery, TU Teaching Hospital, Institute of Medicine, Tribhuvan University
  • Sujeet Poudyal Department of Urology and Kidney Transplant Surgery, TU Teaching Hospital, Institute of Medicine, Tribhuvan University
  • Prem Raj Gyawali Department of Urology and Kidney Transplant Surgery, TU Teaching Hospital, Institute of Medicine, Tribhuvan University
  • Uttam Kumar Sharma Department of Urology and Kidney Transplant Surgery, TU Teaching Hospital, Institute of Medicine, Tribhuvan University
  • Bhola Raj Joshi Department of Urology, Nepal Medical College Teaching Hospital

Abstract

Introduction: Exit strategy at the end of percutaneous nephrolithotomy (PCNL) differs from center to center and patient to patient. Standard PCNL has been practiced so far with minor postoperative morbidities. Tubeless PCNL, which obviates most of the nephrostomy related morbidities, has been challenged for its safety. So this study was conducted to compare the safety and morbidity of tubeless PCNL with standard PCNL.
Methods: Patients who had undergone PCNL, were randomized into group 1 (standard) and group 2 (tubeless) using computer generated random table. In group 1, nephrostomy tube was placed at the end of the procedure and tubes were omitted in group 2 patients. All preoperative, intraoperative and postoperative parameters were recorded and compared in between the groups.
Results: Ninety six PCNLs were randomized into group 1 (47 patients) and group 2 (49 patients). Patients’ characteristics including age, sex, comorbidities, preoperative parameters, size and number of stones and mean operation time were comparable in between the groups. The incidence of postoperative fever, pain and analgesic requirement and urinary leak were found more in group 1 patients. The incidence of postoperative complications and events were comparable in both the groups except for blood transfusion. The mean length of postoperative hospital stay for patients in group 2 was significantly low as compared to group 1.
Published
2018-07-01
How to Cite
CHALISE, Pawan Raj et al. Is nephrostomy tube a rule following all Percutaneous Nephrolithotomy (PCNL)?. Journal of Society of Surgeons of Nepal (JSSN), [S.l.], v. 20, n. 2, p. 43-48, july 2018. ISSN 2392-4772. Available at: <http://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=296>. Date accessed: 17 oct. 2018.
Section
Original Article