A Prospective Study of Efficacy And Safety of Standard Versus Tubeless Percutaneous Nephrolithotomy

Authors

  • K. Senthilnathan Senior Assistant Professor, Department of Urology, Thanjavur Medical College, Thanjavur, India
  • R. Vinoth Kumar Assistant Professor, Department of Urology, Aarupadai Veedu Medical College and Hospital, Puducherry, India

Keywords:

Percutaneous nephrolithotomy, COPD, CKD, hypertension, diabetes mellitus.

Abstract

Introduction: PCNL is considered to be the standard procedure in patients with large renal calculus. The essential step in standard percutaneous nephrolithotomy (PCNL) procedure is placement of a percutaneous nephrostomy tube for drainage. On the other hand, in recent years, the procedure has been reformed to one called as 'tubeless' PCNL in which a double-J stent without nephrostomy tube is placed for internal drainage.
Materials and Methods: This was a prospective comparative study, conducted in the department of Urology, Arupadai Veedu Medical College, Puducherry a period of 12 months from March 2020 to February 2021. A total number of 108 cases of tubeless PCNL was studied data collected and results analysed. Sample size estimated based on prevalence of the operable renal calculi (using formula S =4pq/l2) Results of study group were compared with other group of traditional PCNL with 116 patients. Results: We evaluated the data of 224 cases undergoing PCNL in our hospital. We divided total cases in to 2 groups. There are 108 cases in group A who underwent totally tubeless PCNL and 116 patents in group B of traditional PCNL. Both groups has similar demographics according to age sex and comorbidities. Among these 108 cases (group A) 70 were male and 38 female patients. Male to female ratio is 1.66:1. The average age was 44.6 years with arrange of 20 to 65 years. Where as in group B male to female ratio is 2.3:1 and average age is 48.8 years. Out of 108 cases 12.9% (14) have hypertension, 9.25% (10) have diabetes mellitus, 4 patients have COPDs, 2 patients had hypothyroidism and 2 patients was known CKD. Conclusion: Our findings demonstrated that tubeless PCNLs can be safely and effectively performed by an experienced endourologic team without limiting the number of eligible candidates by preoperative patient selection. Tubeless PCNL has an obvious advantage of significantly reduced postoperative pain, less analgesic requirement and shorter hospital stays. Complications rate are less with tubeless PCNL and blood transfusion is less when compared with traditional PCNL. We believe that this study will contribute to the further popularization of the tubeless technique for the benefit of the patient, the medical team, and the health care system.

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Published

2022-01-04

How to Cite

K. Senthilnathan, & R. Vinoth Kumar. (2022). A Prospective Study of Efficacy And Safety of Standard Versus Tubeless Percutaneous Nephrolithotomy. International Journal of Health and Clinical Research, 4(23), 11–13. Retrieved from https://www.ijhcr.com/index.php/ijhcr/article/view/3837