27444
document
The efficacy of conventional PCNL and two modifications to standard procedure . OBJECTIVE To compare the efficacy of conventional Percutaneous Nephrolithotomy ( PCNL ) with two of its modified procedures . METHODS A randomized controlled trial , was performed on 60 patients undergoing PCNL . Cases of renal stone regardless of stone size and configuration , having pre-operative negative urine culture , no coagulopathy , and no visible residual stone in intra-operative fluoroscopy , were included . They were randomly divided into 3 groups of 20 cases each with nephrostomy tube ( NT ) and temporary ureteral catheter ( TU ) in group A , only TU in group B and only indwelling ureteral catheter ( IU ) in group C. Mean age of cases were 43.2 ( 25-70 ) , 40.1 ( 25-73 ) , and 44 ( 25-70 ) years in groups A , B and C , respectively ( P = 0.6 ) . Procedures were performed under general anaesthesia , using standard techniques for access and lithotomy . Forty-eight hours , 2 weeks and 3 months after PCNL , plain X-ray abdomen , ultrasonography and IVP were performed for each case . RESULTS Only one case in group A had urinary leakage after removal of nephrostomy tube . No cases in the other two groups encountered this problem . There was no haemorrhagic episode . Ultrasonic evaluation showed mild residue in 3 , 1 and 1 cases of groups A , B and C , respectively ( P = 0.2 ) . No collective fluid was found in these groups . IVP showed dilatation without obstruction in 3 subjects of group A and none in group B or C ( P = 0.03 ) . CONCLUSION Tubeless PCNL seems to be accompanied by better outcome . So , further evaluation on more patients seems necessary .
27445
Intervention_Control
conventional PCNL
27446
Intervention_Control
conventional Percutaneous Nephrolithotomy ( PCNL )
27447
Intervention_Control
PCNL
27448
Intervention_Physical
nephrostomy tube ( NT )
27449
Intervention_Physical
temporary ureteral catheter ( TU )
27450
Intervention_Physical
only TU
27451
Intervention_Physical
only indwelling ureteral catheter ( IU )
27452
Intervention_Surgical
PCNL
27453
Intervention_Surgical
Tubeless PCNL
27454
Outcome_Adverse-effects
urinary leakage
27455
Outcome_Adverse-effects
haemorrhagic episode
27456
Outcome_Adverse-effects
mild residue
27457
Outcome_Adverse-effects
collective fluid
27458
Outcome_Adverse-effects
dilatation without obstruction
27459
Participant_Sample-size
60
27460
Participant_Condition
PCNL
27461
Participant_Condition
Cases of renal stone
27462
Participant_Age
age of cases were 43.2 ( 25-70 ) , 40.1 ( 25-73 ) , and 44 ( 25-70 ) years