Document Detail


Nephrostomy tube after percutaneous nephrolithotomy: large-bore or pigtail catheter?
MedLine Citation:
PMID:  11110567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: A nephrostomy tube is an integral part of any percutaneous renal surgery. Commonly, a nephrostomy tube that is 2F to 3F smaller than the percutaneous tract is used after percutaneous nephrolithotomy (PCNL). In our experience, quite a few patients have pain at the nephrostomy tube site, and many patients complain of a prolonged urinary leak after tube removal when a large nephrostomy tube is used. This prospective study was planned to document whether these symptoms could be attributed to the size of the nephrostomy tube and whether a small pigtail catheter could reduce these problems without increasing complications. PATIENTS AND METHODS: Forty well-matched patients in whom a one-stage PCNL was done for calculus disease were studied prospectively. Alternate patients had a 28F nephrostomy tube or a 9F pigtail catheter placed at the end of the procedure. Patients were observed for the duration of hematuria, number of analgesic injections needed, and the duration of urinary leak after tube removal. RESULTS: The groups were comparable in the amount and duration of hematuria after PCNL. There was a statistically significant difference in the analgesic need and the duration of urinary leak after tube removal, both of which were less in patients having a pigtail catheter. CONCLUSIONS: A pigtail catheter nephrostomy tube after PCNL reduces the hospital stay by reducing the duration of the urinary leak. The postoperative course is smooth, as patient has less pain and needs less analgesic support. There is no statistically significant increase in the postoperative bleeding secondary to use of a pigtail catheter. Second-look nephroscopy was easy in the one patient with a pigtail nephrostomy catheter who needed the procedure.
Authors:
P N Maheshwari; M G Andankar; M Bansal
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  14     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-03-01     Completed Date:  2001-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  735-7; discussion 737-8     Citation Subset:  IM    
Affiliation:
R.G. Stone Urological Research Institute, Mumbai, India. calgrse@bom5.vsnl.net.in
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheterization / instrumentation*
Equipment Design
Hematuria / prevention & control
Humans
Kidney Calculi / radiography,  surgery*
Nephrostomy, Percutaneous / instrumentation*
Observer Variation
Postoperative Hemorrhage / prevention & control
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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