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document
Tubeless percutaneous nephrolithotomy : safe even in supracostal access . PURPOSE This study was designed to determine the outcome and safety of tubeless percutaneous nephrolithotomy ( PCNL ) in the treatment of renal calculi . PATIENTS AND METHODS Between November 2005 and March 2006 , 48 patients were randomized to either an 18F Re-entry nephrostomy tube ( group 1 ) or a 6F Double-J stent ( group 2 ) . The two groups were well matched for age , sex , stone size , stone laterality , and number of previous renal procedures . All PCNL procedures were performed by the same surgeon . Postoperative visual analog pain scale ( VAS ) scores at 8 and 24 hours and 14 days after surgery , in-hospital analgesic use , length of hospital stay , success rate , blood transfusion rate , and postoperative complications were compared for the two groups . RESULTS The mean hospital stays in groups 1 and 2 were 3.1 and 1.6 days , respectively ( P = 0.003 ) . The mean VAS scores 8 and 24 hours after surgery were significantly lower in group 2 than in group 1 ( P = 0.001 ) . The postoperative analgesic requirement ( diclofenac sodium ) was significantly higher in group 1 ( 263 mg ) than in group 2 ( 120 mg ; P = 0.02 ) . The rate of blood transfusion in the two groups was similar ( P = NS ) . There was no difference between the groups in VAS scores on postoperative day 14 . The number of supracostal accesses was significantly higher in group 2 than in group 1 ( P = 0.02 ) . The stone-free rates and the numbers of patients with insignificant residual fragments were similar in the two groups . There was no urine leakage or formation of urinoma in patients with Double-J stents . CONCLUSION Tubeless PCNL is safe and effective even after supracostal access and is associated with less postoperative pain and a shorter hospital stay .
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Intervention_Surgical
Tubeless percutaneous nephrolithotomy
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Intervention_Surgical
tubeless percutaneous nephrolithotomy ( PCNL )
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Intervention_Surgical
18F Re-entry nephrostomy tube
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Intervention_Surgical
6F Double-J stent
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Intervention_Pharmacological
( diclofenac sodium )
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Intervention_Surgical
Tubeless PCNL
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Outcome_Other
outcome
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Outcome_Other
safety
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Outcome_Pain
Postoperative visual analog pain scale ( VAS ) scores
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Outcome_Other
in-hospital analgesic use , length of hospital stay
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Outcome_Other
success rate
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Outcome_Other
blood transfusion rate
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Outcome_Adverse-effects
postoperative complications
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Outcome_Other
mean hospital stays
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Outcome_Pain
mean VAS scores
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Outcome_Pain
postoperative analgesic requirement
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Outcome_Physical
rate of blood transfusion
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Outcome_Pain
VAS scores
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Outcome_Physical
number of supracostal accesses
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Outcome_Physical
stone-free rates
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Outcome_Physical
insignificant residual fragments
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Outcome_Adverse-effects
no urine leakage or formation of urinoma
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Outcome_Pain
postoperative pain
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Outcome_Other
shorter hospital stay
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Participant_Condition
renal calculi
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Participant_Sample-size
48