Tubeless versus standard PCNL in geriatric population.

Percutaneous nephrolithotomy (PCNL) is a standard, safe, and efficient method for large-volume renal calculi for all age groups. Nephrostomy tube constitutes an invaluable part of the nephrolithotomy operation. However, the nephrostomy tube has been recently replaced with ureteral catheter or double J-stent thanks to advances in urotechnology and operation equipment. The aim of the current article was to evaluate the safety and reliability of tubeless percutaneous nephrolithotomy in the geriatric population. Between January 2009 and September 2013, a total of 52 patients aged 65 years or elder with renal calculi bigger than 2cm underwent PCNL operation. The first group of 25 patients (48%) with a mean age of 70.0 years (std:±3,8) underwent tubeless PCNL whereas the second group consisting of 27 (52%) patients with a mean age of 71.3 years (std: ±4,0) underwent standard PCNL. The patients were randomly compared retrospectively in terms of burden of calculus, analgesic requirement, creatinine value, renal parenchymal thickness, Body-mass index (BMI), clavien score, length of hospitalization, and being calculus-free. The groups were found to be similar in age, BMI, and gender (P>.05). Burden of calculus, duration of operation, and rate of narcotic analgesic use were found to be statistically significantly higher in the group of Standard PCNL group than in the Tubeless PCNL group (P<.05). Length of hospital stay was 1.7 days in the group of tubeless PCNL and 2.6 days in the standard PCNL group (P<.05). No significant difference was found between the groups in terms of fall in hemoglobin, creatinine, values of parenchymal thickness, and clavien score, preoperative blood transfusion, previous SWL, location of calculi, number of access, and rate of success (P>.05). Burden of calculus was 900 mm2 (304-4232) in the standard PCNL group and 600mm(2) (220-2660) in the tubeless PCNL group with the difference being statistically significant (P=.014). Overall success was achieved in 96.0 and 96.3% of tubeless PCNL and standard PCNL patients after one session of PCNL, respectively. Tubeless percutaneous nephrolithotomy was found to be as safe and effective as standard PCNL in the geriatric population. It is recommended especially in this group of patients because of its advantages such as shorter length of hospitalization, less analgesic requirement, and earlier mobilization.

Ozturk H 《-》

Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial.

Moosanejad N ，Firouzian A ，Hashemi SA ，Bahari M ，Fazli M ... -  《-》

Tubeless percutaneous nephrolithotomy: a prospective feasibility study and review of previous reports.

Shah HN ，Kausik VB ，Hegde SS ，Shah JN ，Bansal MB ... -  《BJU INTERNATIONAL》

Totally tubeless versus standard percutaneous nephrolithotomy for renal stones: analysis of clinical outcomes and cost.

Choi SW ，Kim KS ，Kim JH ，Park YH ，Bae WJ ，Hong SH ，Lee JY ，Kim SW ，Hwang TK ，Cho HJ ... -  《-》

A randomized comparison of tubeless and standard percutaneous nephrolithotomy.

Agrawal MS ，Agrawal M ，Gupta A ，Bansal S ，Yadav A ，Goyal J ... -  《JOURNAL OF ENDOUROLOGY》