Mazhar Ali Channa, Abdul Saboor Soomro, Abdul Khalique, Pardip, Ghulam Mustafa, Mudasir Hussain, Manzoor Hussain

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.

Keywords: Percutaneous nephrolithotomy (PCNL), Clavien-Dindo classification, Complication



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