Indications and Safety of Tubeless Percutaneous Nephrostolithotomy / 中国微创外科杂志

ABSTRACT

Objective To explore indications and safety of tubeless percutaneous nephrolithotomy(PCNL).MethodsPatients were enrolled into this study at the end of PCNL according to their pre-and intra-operative conditions.The inclusion criteria includedthe degree of nephrohydrosis by preoperative B-ultrasonography less than 4 cm;preoperative level of serum creatinine is normal;single percutaneous tract;no sign of urinary infection before and during operation;no obvious operative bleeding or severe collecting system perforation;no residual stone or with small residual stone but no need for second percutaneous operation;operation time for PNCL less than 2 hours(double-J tube placement was placed successfully).A total of 240 patients with upper ureteral calculi or renal stones were selected and randomly allocated to no nephrostomy drainage(Group A,120 patients) or standard(F14) nephrostomy drainage(Group B,120 patients) groups according to the parity of the patients' number. Results PCNL was completed successfully in both the groups with a high rate of stone clearance [98.3%(118/120) vs 96.7%(116/120),?2=0.171,P=0.679].No patient required blood transfusion.After the operation,18 patients showed fever but without infectious shock(Group A 8 vs Group B 10,?2=0.240,P=0.624).No perinephric fluidity was observed by B-ultrasonography either in Group A or Group B in 48 hours after the surgery.Conclusions As for strictly selected patients,tubeless PCNL is a safe and effective treatment.