The efficiency of totally tubeless percutaneous nephrolithotomy: analysis of 40 cases
- Authors: Berezhnoy A.G.1,2, Dunaevskaya S.S.1,2, Ershov А.V.1,2
-
Affiliations:
- Krasnoyarsk State Medical University” named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia
- KB “RJD-Medicine”
- Issue: No 6 (2023)
- Pages: 68-71
- Section: Original Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/626071
- DOI: https://doi.org/10.18565/urology.2023.6.68-71
- ID: 626071
Cite item
Open Access
Access granted
Abstract
Introduction. Previously, the placement of a nephrostomy tube was considered standard practice during percutaneous nephrolithotomy (PCNL) to ensure repeat access and kidney assessment. However, some publications have shown that in certain cases, a totally tubeless approach may be a viable alternative, provided that PCNL is performed properly and safely.
Aim. To analyze the results and complications of totally tubeless PCNL.
Materials and methods. A retrospective analysis of 40 patients with renal stones who underwent totally tubeless PCNL using a single percutaneous access of 16 Ch or 26 Ch at the urology department of NUZ KB “RJD-Medicine”, Krasnoyarsk, Russia, from September 2021 to March 2023, was carried out. Factors that could affect the efficiency and safety of PCNL were analyzed.
Results. The mean duration of the procedure was 39.6 ± 14.4 minutes. The average decrease in hemoglobin level was 5.9 ± 5.5. Narcotic analgesics were used postoperatively in 17.5% (7) of patients. The mean length of stay was 4.7 ± 1.1 days. Transient fever was observed in 4 (10%) cases. In one case, an exacerbation of chronic pyelonephritis developed. There were no cases of significant bleeding during the PCNL, and no patients required blood transfusion.
Conclusions. Our results confirm that totally tubeless PNL is a safe alternative to standard procedure and is not associated with an increased risk of early postoperative complications. This technique is efficient and safe for kidney stones and may be recommended for a select group of patients.
Full Text
About the authors
A. G. Berezhnoy
Krasnoyarsk State Medical University” named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia; KB “RJD-Medicine”
Author for correspondence.
Email: alekb2008@yandex.ru
ORCID iD: 0000-0002-7487-8671
Ph.D., MD, associate professor
Russian Federation, Krasnoyarsk; KrasnoyarskS. S. Dunaevskaya
Krasnoyarsk State Medical University” named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia; KB “RJD-Medicine”
Email: vikto-potapenk@yandex.ru
ORCID iD: 0000-0003-2820-4737
Ph.D., MD, professor
Russian Federation, Krasnoyarsk; KrasnoyarskА. V. Ershov
Krasnoyarsk State Medical University” named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia; KB “RJD-Medicine”
Email: ershov1989@mail.ru
ORCID iD: 0000-0001-5646-9279
Ph.D., assistant
Russian Federation, Krasnoyarsk; KrasnoyarskReferences
- Berezhnoy A.G., Dunaevskaya S.S. Modern surgical methods for the treatment of urolithiasis. Russian Medical Inquiry. 2021;5(3):118–122. doi: 10.32364/2587-6821-2021-5-3-118-122. Russian (Бережной А.Г., Дунаевская С.С. Современные принципы хирургического лечения мочекаменной болезни. РМЖ. Медицинское обозрение. 2021;5(3):118–122. doi: 10.32364/2587-6821-2021-5-3-118-122).
- Gadzhiev N.K., Grigorev V.E., Mazurenko D.A., Malkhasyan V.A., Obidnyak V.M., Pisarev A.V., Tagirov N.S., Popov S.V., Petrov S.B. The ACS system: a new way of prognosis for the effectiveness of percutaneous nephrolithotomy. Experimental and clinical urology. 2016;3:52–56. Russian (Гаджиев Н.К., Григорьев В.Е., Мазуренко Д.А., Малхасян В.А., Обидняк В.М., Писарев А.В., Тагиров Н.С., Попов С.В., Петров С.Б. Система «ACS» или новый способ прогнозирования эффективности перекутанной нефролитотомии. Экспериментальная и клиническая урология. 2016;3 52–56).
- Gauhar V., Traxer O., García Rojo E., et al. Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: a systematic review and meta-analysis of randomized clinical trials. Urolithiasis. 2022;50(5):511–522. doi: 10.1007/s00240-022- 01337-y.
- Gudeman S.R., Stroup S.P., Durbin J.M., Patino G., L’Esperance J.O., Auge B.K. Percutaneous stone surgery using a tubeless technique with fibrin sealant: report of our first 107 cases. BJU Int. 2012;110(11 Pt C):E1048–1052. doi: 10.1111/j.1464-410X.2012.11209.x.
- Berezhnoy A.G., Dunaevskaya S.S., Ershov A.V. Clinical example of percutaneous nephrolitholapaxis of complete coral stone in a patient with lumbar renal dystopia. Siberian Medical Review. 2021;6:94–98. Russian (Бережной А.Г., Дунаевская С.С., Ершов А.В. Клинический пример перкутанной нефролитолапаксии полного коралловидного камня у пациента с поясничной дистопией почки. Сибирское медицинское обозрение. 2021;6:94–98).
- Güler A., et al. Comparison of miniaturized percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for the treatment of large kidney stones: a randomized prospective study. Urolithiasis. 2019;47(3):289–295.
- Li Q., Gao L., Li J., Zhang Y., Jiang Q. Total tubeless versus standard percutaneous nephrolithotomy: a meta-analysis. Minim Invasive Ther Allied Technol. 2020;29(2):61–69. doi: 10.1080/13645706.2019.1581224.
- Ahmad M., Mumtaz H., Hussain H.U., Sarfraz S., Rahat M., Mumtaz S. A prospective, single-centered, cohort study comparing the treatment of renal stones by following PCNL types: Standard, tubeless & totally tubeless. Ann Med Surg (Lond). 2022;80:104325. Published 2022 Aug 4. doi: 10.1016/j.amsu.2022.104325.
- Aghamir S.M.K., Heidari R., Bayesh S., Salavati A., Elmimehr R. Are Nephrostomy and Ureteral Stent Necessary after Multi-Access Percutaneous Nephrolithotomy?. Curr Urol. 2019;13(3):141–144. doi: 10.1159/000499279.
- Guo S., Zhang X., Li F., Sun C., Zhang Y., doi: Cao X. One-stage tubeless percutaneous nephrolithotomy for asymptomatic calculous pyonephrosis. BMC Urol. 2022;22(1):29. doi: 10.1186/s12894-022-00983-z.
- Kaprin A.D., Apolikhin O.I., Sivkov A.V., Anokhin N.V., Gadzhiev N.K., Malkhasyan V.A., Akopyan G.N., Prosyannikov M.Yu. The incidence of urolithiasis in the Russian Federation from 2005 to 2020. Experimental and Clinical Urology. 2022;15(2)10–17. doi: 10.29188/2222-8543-2022-15-2-10-17
- Lin C.H.., Lin Y.C., Chiang H.C. et al. Totally tubeless single access tract mini-percutaneous nephrolithotripsy in treatment of large burden > 2-cm and/or complex renal stones: a case series of 62 patients. BMC Urol. 2022;22:61. doi: 10.1186/s12894-022-01012-9.
Supplementary files
