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Totally tubeless percutaneous nephrolithotomy in selected patients with kidney stones

Year 2014, Volume: 41 Issue: 2, 298 - 302, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0420

Abstract

Objectives: Percutaneous nephrolithotomy (PNL) is the first-line treatment for large and complex renal calculi. The aim of this study is to evaluate the outcomes of totally tubeless PNL operations. Methods: Between October 2009 and August 2013, outcomes of 68 (23.4%) patients treated with totally tubeless PNL method at our clinic were analyzed. Stone disintegration was performed with a pneumatic lithotriptor. Operative findings, duration of hospital stay, analgesia requirement and success rates were retrospectively analyzed performed with totally tubeless PNL. Results: Mean age of patients treated with the totally tubeless PNL was 43.4 ± 13.6 (18-69) years and there were 42 (61,7%) men and 26 (38,2%) women. Mean operation time, excluding the preparation course, was 39.5±14.8 (25-90) minutes and mean fluoroscopy time was 6.04±4.15 (1-12) minutes. None of the patients demonstrated a urinoma, hemorrhage or residual stones in postoperative ultrasonography and plain radiograph. Two patients had undergone ureterorenoscopy for prolonged leakage of urine and treated by retrograde ureteral double-J stent. Blood transfusion was needed only in two patients. The mean hospitalization time was 1.27±0.36 (1-2) days. Conclusion: We think that totally tubeless PNL may be used in properly suitable cases with mil-moderate stone load, intact counterside kidney and without any significant complication and need for second- look.

References

  • Fernstrom I, Johansson B. Percutenous pyelolithotomy: A new extraction technique. Scand J Urol Nephrol 1976;10:257-259.
  • Tefekli A, Tepeler A, Altundere F, et al. Tubeless percutane- ous nephrolithotomy in selected patients. Turkish journal of urology 2006;32:240-247.
  • Bellman GC, Davidoff R, CandelaJ, et al. Tubeless percuta- neous renal surgery. J Urol 1997;157:1578-1582.
  • Akarer G, Akay A, Akar Z, et al. Results of percutaneous nephrolithotomy performed in a regional state hospital. J Clin Exp Invest 2011;2:371-374.
  • Paul EM, Markovic R, Lee BR, Smith AD. Choosing the ideal nephrostomy tube. BJU Int 2003;92:672-677.
  • Pietrow PK, Auge BK Lallas CD, Santa-Cruz RW, et al. Pain after percuteneous nephrolithotomy ; impact of nephros- tomy tube size. J Endourol 2003;17:411-414.
  • Liatsikos EN, Hom D, Dinlenc CZ, et al. Tail stent versus re-entry tube: a randomized comparison after percutaneous stone extraction. Urology 2002;59:15-21.
  • Marcovich R, Jacobson AI, Singh J, et al. No panacea for drainage after percutaneous nephrolithotomy. J Endourol 2004;18:743-747.
  • Wickham JEA, Miller RA, Kellett MJ, Payne SR. Per- cutaneous nephrolithotomy: one stage or two? Br J Urol 1984;56:582-584.
  • Winfield HN, Weyman P, Clayman RV. Percutaneous neph- rostolithotomy: complications of premature nephrostomy tube removal. J Urol 1986;136:77-79.
  • Yang RM, Bellman GC. Tubeless percutaneous renal sur- gery in obese patients. Urology 2004;63:1036-1040.
  • Singh I, Saran R, Jain M. Does sealing of the tract with absorbable gelatin (spongostan) facilitate tubeless PCNL? A prospective study. J Endourol 2008;22:2485-2493.
  • Falahatkar S, Khosropanah I, Roshani A, et al. Tubeless percutaneous nephrolithotomy for staghorn stones. J En- dourol 2008;22:1447-1451.
  • Shah HN, Mahajan AP, Hedge SS, Bansal M. Tubeless per- cutaneous nephrolitotomy in patients with previous ipsilat- eral open renal surgery: a feasibility study with review of literature. J Endourol 2008;22:19-24.
  • Aghamir SM, Hosseini SR, Gooran S. Totally tubeless per- cutaneous nephrolithotomy. J Endourol 2004;18:647-662.
  • Karami H, Gholamrezaie HR. Totally tubeless percuta- neous nephrolithotomy in selected patients. J Endourol 2004;18:475-476.
  • Istanbulluoglu OM, Ozturk B, Cicek T, et al. Case report: Bilateral simultaneous tubeless and stentless percutaneous nephrolitotomy. J Endourol 2008;22:25-27.

Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi

Year 2014, Volume: 41 Issue: 2, 298 - 302, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0420

Abstract

Amaç: Perkütan nefrolitotomi (PNL) büyük ve kompleks böbrek taşı tedavisinde ilk seçenek tedavidir. Bu çalışmanın amacı tamamen tüpsüz PNL operasyonu uygulanan hastaların sonuçlarını değerlendirmektir. Yöntemler: Kliniğimizde, Ekim 2009 – Ağustos 2013 tarihleri arasında böbrek taşı olan 68 (%23,4) olguda uygulanan tam tüpsüz PNL yönteminin sonuçları değerlendirildi. Taşlar pnömatik litotriptor ile kırıldı. Tamamen tüpsüz PNL uygulanan hastaların, ameliyatla ilgili bulguları, hastanede kalış süreleri, analjezik ihtiyacı ve başarı oranları geriye dönük olarak incelendi. Bulgular: Tam tüpsüz PNL yapılan hastaların yaş ortalaması 43,4 ± 13,6 (18-69) yıl olarak hesaplandı ve hastaların 42 (%61,7) tanesi erkek, 26 (%38,2) tanesi kadındı. Ortalama operasyon süresi, hazırlık dönemi hariç 39,5±14,8 (25-90) dakika ve ortalama skopi süresi 6,04±4,15 (1-12) olarak hesaplandı. Hiçbir hastada postoperatif birinci günde yapılan ultrasonografide ve direk üriner sistem grafisinde, ürinom kanama ya da rezidü taşa rastlanmadı. İki hastada, perkütan giriş yerinde uzamış ıslatma olması üzerine üreterorenoskopi uygulandı ve retrograd üreteral stent kondu. Kan transfüzyonuna sadece iki hastada ihtiyaç duyuldu. Ortalama hastanede kalış süresi 1,27±0,36 (1-2) gündü. Sonuçlar: Tam tüpsüz PNL\'nin, hafif orta taş yükü ve karşı böbreği sağlam olan ve ciddi komplikasyonu olmayan, tekrar PNL gerektirmeyecek uygun hastalarda kullanılabileceğini düşünmekteyiz.

References

  • Fernstrom I, Johansson B. Percutenous pyelolithotomy: A new extraction technique. Scand J Urol Nephrol 1976;10:257-259.
  • Tefekli A, Tepeler A, Altundere F, et al. Tubeless percutane- ous nephrolithotomy in selected patients. Turkish journal of urology 2006;32:240-247.
  • Bellman GC, Davidoff R, CandelaJ, et al. Tubeless percuta- neous renal surgery. J Urol 1997;157:1578-1582.
  • Akarer G, Akay A, Akar Z, et al. Results of percutaneous nephrolithotomy performed in a regional state hospital. J Clin Exp Invest 2011;2:371-374.
  • Paul EM, Markovic R, Lee BR, Smith AD. Choosing the ideal nephrostomy tube. BJU Int 2003;92:672-677.
  • Pietrow PK, Auge BK Lallas CD, Santa-Cruz RW, et al. Pain after percuteneous nephrolithotomy ; impact of nephros- tomy tube size. J Endourol 2003;17:411-414.
  • Liatsikos EN, Hom D, Dinlenc CZ, et al. Tail stent versus re-entry tube: a randomized comparison after percutaneous stone extraction. Urology 2002;59:15-21.
  • Marcovich R, Jacobson AI, Singh J, et al. No panacea for drainage after percutaneous nephrolithotomy. J Endourol 2004;18:743-747.
  • Wickham JEA, Miller RA, Kellett MJ, Payne SR. Per- cutaneous nephrolithotomy: one stage or two? Br J Urol 1984;56:582-584.
  • Winfield HN, Weyman P, Clayman RV. Percutaneous neph- rostolithotomy: complications of premature nephrostomy tube removal. J Urol 1986;136:77-79.
  • Yang RM, Bellman GC. Tubeless percutaneous renal sur- gery in obese patients. Urology 2004;63:1036-1040.
  • Singh I, Saran R, Jain M. Does sealing of the tract with absorbable gelatin (spongostan) facilitate tubeless PCNL? A prospective study. J Endourol 2008;22:2485-2493.
  • Falahatkar S, Khosropanah I, Roshani A, et al. Tubeless percutaneous nephrolithotomy for staghorn stones. J En- dourol 2008;22:1447-1451.
  • Shah HN, Mahajan AP, Hedge SS, Bansal M. Tubeless per- cutaneous nephrolitotomy in patients with previous ipsilat- eral open renal surgery: a feasibility study with review of literature. J Endourol 2008;22:19-24.
  • Aghamir SM, Hosseini SR, Gooran S. Totally tubeless per- cutaneous nephrolithotomy. J Endourol 2004;18:647-662.
  • Karami H, Gholamrezaie HR. Totally tubeless percuta- neous nephrolithotomy in selected patients. J Endourol 2004;18:475-476.
  • Istanbulluoglu OM, Ozturk B, Cicek T, et al. Case report: Bilateral simultaneous tubeless and stentless percutaneous nephrolitotomy. J Endourol 2008;22:25-27.
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Cemil Aydın This is me

Ramazan Topaktaş This is me

Zeynep Banu Aydın This is me

Selçuk Altın This is me

Ali Akkoç This is me

Aykut Aykaç This is me

Fuat Demirel This is me

Publication Date June 1, 2014
Submission Date March 2, 2015
Published in Issue Year 2014 Volume: 41 Issue: 2

Cite

APA Aydın, C., Topaktaş, R., Aydın, Z. B., Altın, S., et al. (2014). Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi. Dicle Tıp Dergisi, 41(2), 298-302. https://doi.org/10.5798/diclemedj.0921.2014.02.0420
AMA Aydın C, Topaktaş R, Aydın ZB, Altın S, Akkoç A, Aykaç A, Demirel F. Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi. diclemedj. June 2014;41(2):298-302. doi:10.5798/diclemedj.0921.2014.02.0420
Chicago Aydın, Cemil, Ramazan Topaktaş, Zeynep Banu Aydın, Selçuk Altın, Ali Akkoç, Aykut Aykaç, and Fuat Demirel. “Seçilmiş böbrek taşı olgularında Tamamen tüpsüz perkütan Nefrolitotomi”. Dicle Tıp Dergisi 41, no. 2 (June 2014): 298-302. https://doi.org/10.5798/diclemedj.0921.2014.02.0420.
EndNote Aydın C, Topaktaş R, Aydın ZB, Altın S, Akkoç A, Aykaç A, Demirel F (June 1, 2014) Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi. Dicle Tıp Dergisi 41 2 298–302.
IEEE C. Aydın, “Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi”, diclemedj, vol. 41, no. 2, pp. 298–302, 2014, doi: 10.5798/diclemedj.0921.2014.02.0420.
ISNAD Aydın, Cemil et al. “Seçilmiş böbrek taşı olgularında Tamamen tüpsüz perkütan Nefrolitotomi”. Dicle Tıp Dergisi 41/2 (June 2014), 298-302. https://doi.org/10.5798/diclemedj.0921.2014.02.0420.
JAMA Aydın C, Topaktaş R, Aydın ZB, Altın S, Akkoç A, Aykaç A, Demirel F. Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi. diclemedj. 2014;41:298–302.
MLA Aydın, Cemil et al. “Seçilmiş böbrek taşı olgularında Tamamen tüpsüz perkütan Nefrolitotomi”. Dicle Tıp Dergisi, vol. 41, no. 2, 2014, pp. 298-02, doi:10.5798/diclemedj.0921.2014.02.0420.
Vancouver Aydın C, Topaktaş R, Aydın ZB, Altın S, Akkoç A, Aykaç A, Demirel F. Seçilmiş böbrek taşı olgularında tamamen tüpsüz perkütan nefrolitotomi. diclemedj. 2014;41(2):298-302.