Practice of Totally Tubeless Nephrolitotomy among Patients with Renal Calculus

Year 2013, Volume: 38 Issue: 4, 636 - 641, 01.12.2013

Musa Ekici İsmail Nalbant Hasan Nedim Göksel Göktuğ Ufuk Öztürk Nevzat Can Şener Abdurrahim İmamoğlu

Abstract

Purpose: We aimed to present the data on totally tubeless nephrolitotomy (PNL) outcomes undergone in our clinic. Materials and Methods: We retrospectively analyzed 140 patients undergone totally tubeless PNL in our clinic between January 2010 and December 2012. Results: Mean patient age was 47,84 (5-73). Mean operative time was 88,8 (45-110) minutes where mean stone area was 375,3 (110-175) mm2 . 92,8% was our stone free rate. Remaining 10 patients had undergone ureterorenoscopy for ureteral stones. Two patients having non-opaque stones had residual kidney stones and treated by SWL. 8 patients (%5,7) needed blood transfusion, 2 patients needed perirenal hematoma and treated conservatively. No patients needed additional treatment or encountered vascular complications. One patient encountered serozal colon injury and treated conservatively. Conclusion: With regard to patient comfort, shorter hospital stay, low analgesic requirement, totally tubeless PNL gained popularity. We believe totally tubeless PNL may be used in suitable cases. Key Words: Kidney Stone, Totally Tubeless, Nephrolithotomy

Keywords

Kidney Stone, Totally Tubeless, Nephrolithotomy

Böbrek Taşı Olgularında Tam Tüpsüz Perkütan Nefrolitotomi Uygulaması

Abstract

Amaç: Bu çalışmada tam tüpsüz perkutan nefrolitotomi (PNL) uygulamasıyla ilgili deneyimlerimiz aktarılmıştır. Materyal-Metod: Ocak 2010-Aralık 2012 tarihleri arasında böbrek taşı olan 140 olguda uygulanan tam tüpsüz PNL yönteminin sonuçları incelendi. Bulgular: Hastaların yaş ortalaması 47,84(5-73) idi. Ortalama operasyon süresi 88.8(45-110) dk, taş alanı ise 375.2(110-175) mm² idi. Taşsızlığa ulaşma oranımız KÖRF dahil 130(%92.8) olarak hesaplandı. PNL uyguladığımız hastalarımızdan 1 tanesinde serozal kolon yaralanması 2 hastada postoperatif perirenal hematom izlendi. Sonuç: Sonuç olarak uygun vakalarda tam tüpsüz PNL, günümüzde böbrek taşı tedavisinde taşsızlığa ulaşma noktasında standart PNL kadar güvenle uygulanabileceğini düşünmekteyiz.

Keywords

Böbrek taşı, Tam Tüpsüz Perkutan Nefrolitotomi

References

• Bdesha AS, Jones CR, North EA, et al. Routine placement of a nephrostomy tube is not necessary after percutaneous nephrostholithotomy. Br J Urol. 1997; 79: 1.
• Marcovich R, Jacobson Al, Singh J, Shah D, ElHakim A, Lee BR, Smith Ad: No panacea for drainage after percutaneous nephrolithotomy.J Endourol. 2004;18:743-7
• Pietrow PK, Auge BK Lallas CD, Santa-Cruz RW, Newman GE, Albala DM, Preminger GM. Pain after percütaneous nephrolithotomy;impact of nephrostomy tube size. J Endourol. 2003; 17:411-4.
• Maheshwari PN, Andankar MG, Bansal M: Nephrostomy tube after percutaneous nephrolithotomy: Large-bo-re or pigtail catheter? J Endourol. 2000; 14: 735Liatsikos EN, Hom D, Dinlenc CZ, et al: Tail stent ver-sus re-entry tube: A randomized comparison after percu-taneous stone extraction. Urology. 2002; 59: 15Bellman GC, Davidoff R, Candela J, et al. Tubeless percutaneous renal surgery. J Urol. 1997; 157:1578.
• Goh M,Wolf JR JS.Almost totally tubeless percütaneous nephrolithotomy;further evolutionof the technique. J Endourol. 1999; 13:177-80.
• Yang RM, Bellman GC: Tubeless percutaneous renal surgery in obese patients. Urology. 2004; 63: 1036
• Jou YC, Cheng MC, Lin CT, Chen PC, Shen JH. Nephrostomy tube-free percutaneous nephrolitotomy for patients with large stones and staghorn stones. Urology. 2006; 67:30-4
• Falahatkar S, Khosropanah I, Roshani A, Neiroomand H, Nikpar S, Nadjafi-Semnani M et al. Tubeless percutaneous nephrolitotomy for staghorn stones. J Endourol. 2008; 22:1447-51.
• Aghamir SM, Hosseini SR, Gooran S. Totally tubeless percutaneous nephrolithotomy. J Endourol. 2004; 18:647-62
• Karami H, Gholamrezaie HR. Totally tubeless percutaneous nephrolithotomy in selected patients. J Endourol. 2004; 18:475-6.
• Karami H, Jabbari M, Arbab AH. Tubeless percutaneous nephrolitotomy: 5 years of experience in 201 patients. J Endourol. 2007; 21:169-72.
• Shah HN, Kausik VB, et al: Safety and efficacy of bila-teral simultaneous tubeless percutaneous nephrolithoto-my. Urology. 2005; 66: 500-4.
• Yazışma Adresi / Address for Correspondence: Dr. Nevzat Can Şener Dışkapı Yıldırım Beyazıd Eğitim ve Araştırma Hastanesi Üroloji Kliniğiı ANKARA e-mail: [e-mail] geliş tarihi/received :06.03.2013 kabul tarihi/accepted:10.04.2013