A randomized controlled study comparing the standard, tubeless, and totally tubeless percutaneous nephrolithotomy procedures for renal stones from a tertiary care hospital
| Autor: | Fredrick Paul, Suresh Bhat, Jithin Lal |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Randomization Blood transfusion business.industry Urology medicine.medical_treatment Analgesic 030232 urology & nephrology Tertiary care hospital lcsh:Diseases of the genitourinary system. Urology lcsh:RC870-923 Surgery law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law 030220 oncology & carcinogenesis Nephrostomy medicine Original Article Percutaneous nephrolithotomy Ureteric stent business |
| Zdroj: | Indian Journal of Urology, Vol 33, Iss 4, Pp 310-314 (2017) Indian Journal of Urology : IJU : Journal of the Urological Society of India |
| ISSN: | 0970-1591 |
| DOI: | 10.4103/iju.iju_52_17 |
| Popis: | Introduction: Percutaneous nephrolithotomy (PCNL) is an effective treatment for renal stones. Due to the significant pain and morbidity after standard PCNL because of nephrostomy tubes, various modifications of PCNL are being performed. We report a randomized trial comparing these modalities. Materials and Methods: A total of 75 patients were randomized into three groups of 25 each: standard PCNL with nephrostomy tubes (Group 1), tubeless PCNL with ureteric stent and no nephrostomy (Group 2), and totally tubeless PCNL without ureteric catheter or nephrostomy (Group 3). Randomization was done at the end of the procedure for those patients satisfying the inclusion criteria based on duration of surgery, single puncture tract, intraoperative bleeding, stone burden, intact pelvicalyceal system, and no residual stones at the end of procedure. The outcomes measured were hemoglobin (Hb) drop, hemorrhage, need for blood transfusion, pyrexia, urine leak, pain score, analgesic requirement, and duration of hospital stay. Results: There was no significant difference in hemorrhage, Hb drop, need for blood transfusion, and postoperative pyrexia among the groups. All patients except one in the standard group only had variable amount of urinary leak. The analgesic requirement and duration of hospital stay attained statistical significance in favor of tubeless and totally tubeless groups compared to the standard. Conclusions: Tubeless and totally tubeless PCNL are safe and effective method of renal stone management. Totally tubeless PCNL significantly reduced postoperative pain and morbidity compared to the tubeless method. |
| Databáze: | OpenAIRE |
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