Tubeless percutaneous nephrolithotomy: outcomes with expanded indications
| Autor: | Xiaobo Liu, Manoj Monga, Mark Noble, Emad Rizkala, Wahib Isac |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Staghorn calculus Time Factors Urology medicine.medical_treatment Perforation (oil well) lcsh:RC870-923 Body Mass Index Kidney Calculi Postoperative Complications Maximum diameter Urolithiasis medicine Humans In patient Percutaneous nephrolithotomy Intraoperative Complications Aged Nephrostomy Percutaneous Retrospective Studies Percutaneous Nephrostomy business.industry Significant difference Middle Aged Length of Stay lcsh:Diseases of the genitourinary system. Urology Surgery Treatment Outcome Multivariate Analysis Female business Complication |
| Zdroj: | International braz j urol, Volume: 40, Issue: 2, Pages: 204-211, Published: APR 2014 International braz j urol v.40 n.2 2014 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International Brazilian Journal of Urology, Vol 40, Iss 2, Pp 204-211 (2014) |
| Popis: | IntroductionTubeless PCNL has been utilized to shorten hospital stay and improve patient postoperative pain control. Prior studies have excluded those patients with significant bleeding or other complications. Our objective was to evaluate the utility of tubeless PCNL in all patients irrespective of intraoperative outcome.Materials and MethodsA retrospective review of the charts of patients who underwent PCNL at our institute was performed. Patients were assigned to one endourologist who routinely performed tubeless PCNL and to a second endourologist who routinely left a small-bore pigtail nephrostomy. Preoperative demographics operative and postoperative outcomes were compared.ResultsOut of 159 patients included, 83 patients had tubeless PCNL while 76 patients had standard PCNL. There was no difference between groups regarding age, gender, ASA score, number, maximum diameter of stones, number of calyces involved, stone density (HU), laterality and use of preoperative narcotics. While staghorn stones were more common in patients who underwent standard PCNL (p = 0.008). Tubeless patients had less number of access tracts (p ≤ 0.001), shorter hospital stay (1.7 vs. 3.0 days, p = 0.001) when compared to standard PCNL group. Multivariable analysis controlling for confounding factors including staghorn calculi and number of accesses confirmed that tubeless PCNL was associated with shorter hospital stay and less postoperative pain. There was no significant difference in complication rates between the two groups.ConclusionOur report confirms the previous reports of shorter hospital stay, less pain and analgesia as compared to standard PCNL, and establishes its safety irrespective of bleeding, perforation, extravasation or other intraoperative issues that have previously been utilized as exclusionary criteria for this approach. |
| Databáze: | OpenAIRE |
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