Document Detail


Tubeless percutaneous nephrolithotomy: is it really less morbid?
MedLine Citation:
PMID:  18355137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate and study the role, relative safety, and effectiveness of "tubeless" percutaneous nephrolithotomy (PCNL) and whether it is really less morbid vis-à-vis PCNL with a nephrostomy tube; to compare the postoperative pain, analgesia requirement, hospital stay, return to work time, and other parameters in patients undergoing tubeless PCNL and standard PCNL. PATIENTS AND METHODS: Sixty selected patients underwent PCNL. A single urologist (IS) was the surgeon, and a resident administered random chit numbers, and recorded pain scores and results of all the chosen parameters. Patients who fulfilled the entry criteria for a tubeless PCNL protocol were randomized to either the omission of a nephrostomy tube (tubeless PCNL with Double-J stent) or to the placement of a 22F nephrostomy tube. The recorded data were analyzed with respect to several parameters. RESULTS: The mean age, stone burden, and preoperative hemoglobin, blood urea, and serum creatinine values were not significantly different between the two groups. However, the operative time (P < 0.001), analgesia requirement (P < 0.001), and hospital stay and time to return to normal activity (P < 0.001) were significantly lower in the tubeless PCNL group. CONCLUSIONS: Significantly less pain, lower analgesia requirement, and shorter hospital stay with early return to normal activities were observed in the tubeless PCNL group v the primary nephrostomy tube PCNL group. Tubeless PCNL in selected patients is a secure, effective, and less morbid procedure that does not compromise patient safety and concerns. We recommend that tubeless PCNL be the preferred procedure in selected patients for management of nephrolithiasis.
Authors:
Iqbal Singh; Arvind Singh; Gyanendra Mittal
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  22     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  427-34     Citation Subset:  IM    
Affiliation:
Division of Urology, University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi, India. iqbalsinghp@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analgesia / utilization
Convalescence
Drainage / adverse effects*,  methods
Female
Humans
Kidney Calculi / surgery*
Male
Middle Aged
Nephrostomy, Percutaneous / adverse effects*,  methods
Pain, Postoperative
Prospective Studies

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


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