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Supracostal Tubeless Percutaneous Nephrolithotomy: A Retrospective Cohort Study.
MedLine Citation:
PMID:  22973820     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and Purpose: To evaluate the safety of tubeless percutaneous nephrolithotomy in patients undergoing supracostal percutaneous renal access. Patients and Methods: Between October 1999 and October 2010, 302 patients underwent percutaneous nephrolithotomy via a supracostal access tract. Two hundred forty-eight patients (82.1%) had a nephrostomy tube placed at the end of the case and 54 (17.9%) did not. The medical records of both cohorts were compared regarding patient demographics (age, sex, body mass index, preoperative creatinine), operative characteristics (estimated blood loss, length of stay, treatment efficacy), and complication rates (overall, thoracic, hemorrhage requiring transfusion). Results: Patient demographics did not differ between the tubeless and nephrostomy tube groups. Estimated blood loss was significantly less in the tubeless patients (67 ml vs 123 ml; p =0.019). The tubeless group had a shorter mean length of stay than the nephrostomy tube group (2.5 vs 3.4 days, p < 0.01). Treatment success was comparable between the two groups (tubeless 81.5% vs nephrostomy tube 77.8%; p = 0.553). Overall complications (p = 0.765) and blood transfusion (p =0.064) rates were equivalent. Chest complications were higher in the tubeless group (22.2%) compared to the nephrostomy tube patients (10.9%) (p = 0.024). Nevertheless, chest complications requiring intervention were not different (p = 0.152). Conclusions: Tubeless supracostal percutaneous nephrolithotomy was associated with less intraoperative blood loss and a shorter hospital stay. Although the tubeless group experienced more chest complications overall, the need for intervention was no different among the two cohorts. Tubeless supracostal percutaneous nephrolithotomy appears safe.
Authors:
Brian Duty; Michael Joseph Conlin; Matthew Wagner; Aaron Bayne; Gregory Adams; Eugene Fuchs
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-13
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Smith Institute for Urology, Urology, 450 Lakeville Rd, New Hyde Park, New York, United States, 11042, 516-734-8567, 516-734-8537; bduty@nshs.edu.
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