Objective: We aimed to compare patient groups who underwent either a standard per- cutaneous nephrolithotomy (PNL) or tubeless PNL for safety, effectiveness and patient com- fort.
Material and Methods: 78 patients were included in the study. Patients who underwent the standard PNL (n=38) or tubeless PNL (n=40) were randomized into Groups 1 and 2, respectively. This study was designed as a pro- spective, randomized, double-blind investiga- tion. Patients who had active bleeding at the end of the operation and those with multiple access tracts were excluded from the study. To evaluate postoperative pain and compli- cations, a visual analogue scale (VAS) and a modified Clavien classification were used, re- spectively.
Results: A statistically significant dif- ference was not found between the two pa- tient groups for demographic data (age and gender), or for size, laterality, and intrarenal location of the stone(s) (p>0.05). Periopera- tive data, including operative and fluorosco- py times and stonefree rates, perioperative changes in creatinine and haemoglobin val- ues, blood transfusion, VAS 2 to 3 pain scores, analgesic requirements, fever and complica- tions requiring additional surgical treatment were not statistically different between groups (p>0.05). A VAS 1 pain score and hospital stays were significantly decreased in the tube- less PNL group (p=0.003).
Conclusions: Tubeless PNL surgery is an effective and safe en- dourological procedure that can be performed by experienced sur- geons. Its advantages over standard PNL include less pain during the early postoperative period, shorter hospital stays but the rates of complications are not significantly lower.
Keywords: Renal Stones Percutaneous Nephrolithotomy, Stan- dard PNL, Tubeless PNL, pain, hospitalization time.
Abstract
Objective: We aimed to compare patient groups who underwent either a standard per- cutaneous nephrolithotomy (PNL) or tubeless PNL for safety, effectiveness and patient com- fort.
Material and Methods: 78 patients were included in the study. Patients who underwent the standard PNL (n=38) or tubeless PNL (n=40) were randomized into Groups 1 and 2, respectively. This study was designed as a pro- spective, randomized, double-blind investiga- tion. Patients who had active bleeding at the end of the operation and those with multiple access tracts were excluded from the study. To evaluate postoperative pain and compli- cations, a visual analogue scale (VAS) and a modified Clavien classification were used, re- spectively.
Results: A statistically significant dif- ference was not found between the two pa- tient groups for demographic data (age and gender), or for size, laterality, and intrarenal location of the stone(s) (p>0.05). Periopera- tive data, including operative and fluorosco- py times and stonefree rates, perioperative changes in creatinine and haemoglobin val- ues, blood transfusion, VAS 2 to 3 pain scores, analgesic requirements, fever and complica- tions requiring additional surgical treatment were not statistically different between groups (p>0.05). A VAS 1 pain score and hospital stays were significantly decreased in the tube- less PNL group (p=0.003).
Conclusions: Tubeless PNL surgery is an effective and safe en- dourological procedure that can be performed by experienced sur- geons. Its advantages over standard PNL include less pain during the early postoperative period, shorter hospital stays but the rates of complications are not significantly lower.
Keywords: Renal Stones Percutaneous Nephrolithotomy, Stan- dard PNL, Tubeless PNL, pain, hospitalization time.