Complications of Standard Percutaneous Nephrolithotomy versus Tubeless Percutaneous Nephrolithotomy
Mazhar Ali Channa, Abdul Saboor Soomro, Abdul Khalique, Pardip, Ghulam Mustafa, Mudasir Hussain, Manzoor Hussain
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ABSTRACT
Objective: To
compare grade I complication as per Clavien-Dindo classification in patients
undergoing standard (with tube) verses tubeless percutaneous nephrolithotomy.
Study
design: Hospital based randomized control study.
Place and
Duration of Study: Urology
Clinic, Sindh Institute of Urology &
Transplantation Karachi from 3rd June 2016 to 2nd December 2016.
Methodology: Seventy
four patients (37patients) in each group were enrolled. In group 1 patients, a
20 F nephrostomy tube were placed in the
kidney over the guide wire, which was removed later. Group II patients
had antegrade placement of a Double-J stent without nephrostomy and the wound
compressed for 5min. The demographic like
age, gender and complications grade I complications according to Clavian-Dindo
classification were noted.
Results: The
mean age was 49.42±7.06 years. There were 46 (62.16%) males and 28 (37.84%)
females. There was no significant difference in stone clearance rate between
the groups; 91.9% in standard percutaneous nephrolithotomyg roup and 94.6% in
tubeless percutaneous nephrolithotomy group. Need for analgesics for pain
control was high in standard percutaneous nephrolithotomy group 86.5% versus
64.9% in tubeless percutaneous nephrolithotomy group (p=0.03). Frequency of
urine leakage was 18.9% in standard percutaneous nephrolithotomy group and only
2.7% in tubeless percutaneous nephrolithotomy group (p=0.02).
Conclusion: Tubeless
percutaneous nephrolithotomy procedure has fewer complications as per
Clavien-Dindo classification regarding need for analgesics and urine leakage.
In suitable cases, the tubeless procedure can be safely used as the standard
for percutaneous nephrolithotomy.