Document Detail


Tubeless percutaneous nephrolithotomy: what about replacing the Double-J stent with a ureteral catheter?
MedLine Citation:
PMID:  18294032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the feasibility and safety of replacing the Double-J stent with a ureteral catheter in tubeless percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: From August 1998 to February 2007, 33 patients underwent tubeless PCNL for renal calculi by the same surgeon. A retrograde 7F ureteral catheter was placed at the beginning of the surgery in all patients. A nephrostomy tube was not used in any patient. At the end of the procedure, the working tract was electrocauterized using a 26F resectoscope with a rollerball electrode; no hemostatic sealant was used. The ureteral catheter was the sole means of drainage left in place. The incidence and type of complications, the operative time, the length of hospitalization, the rate of transfusion, and the degree of pain were obtained by chart review. RESULTS: In this group of patients, the mean stone burden was 17.25 mm. The mean operative time was 71.5 min. The mean length of hospitalization was 1.9 day (range 1 to 7 days). The mean hemoglobin decrease was 0.8 g/dL. No blood transfusions were needed. The mean visual analog pain intensity scale was 1.87. Complications developed in five (15%) patients, of whom one needed a Double-J stent placement. The complications were pyelonephritis, urinary extravasation, sustained hematuria, and renal colic. The ureteral catheter was removed by postoperative day 1 in 91% of patients. CONCLUSIONS: Replacing the Double-J stent with a ureteral catheter in tubeless PCNL is an effective procedure and can be performed in patients with a moderate stone burden. The electrocauterization of the bleeding points at the end of percutaneous renal surgery with a rollerball resectoscope is safe.
Authors:
Pascal Mouracade; Romain Spie; Herve Lang; Didier Jacqmin; Christian Saussine
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  22     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-5     Citation Subset:  IM    
Affiliation:
Department of Urology, Strasbourg University Hospital, Strasbourg, France. pmouracade@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Blood Loss, Surgical / prevention & control
Equipment Design
Feasibility Studies
Female
Follow-Up Studies
Humans
Incidence
Kidney Calculi / radiography,  surgery*
Length of Stay
Male
Middle Aged
Nephrostomy, Percutaneous / instrumentation*
Postoperative Complications / epidemiology,  prevention & control
Prosthesis Implantation / instrumentation*
Retrospective Studies
Stents*
Treatment Outcome
Urinary Catheterization / instrumentation*
Urography

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


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