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Safety and Effectiveness of Externalized Ureteral Catheter in Tubeless Percutaneous Nephrolithotomy

Putu Angga Risky Raharja, Widi Atmoko, Nur Rasyid, Ponco Birowo
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Abstract

Purpose: To review the safety and effectiveness of tubeless percutaneous nephrolithotomy (PCNL) with an externalized ureteral catheter (EUC) compared with standard PCNL with nephrostomy tube and tubeless PCNL with double-J (DJ) stent following uncomplicated PCNL and the absence of residual stones.

Materials and Methods: Patients with kidney stones who underwent uncomplicated PCNL between January 2000 to December 2017 and had no residual stones were retrospectively evaluated. The 766 patients were divided into standard PCNL with nephrostomy tube (group 1; 350 patients), tubeless PCNL with DJ stent (group 2; 189 patients), and tubeless PCNL with EUC (group 3; 227 patients). Demographic characteristics, stone-related factors, perioperative and postoperative parameters were analyzed.

Results: Demographic and stone-related characteristics were comparable. The differences in the mean operative time and complication rates were not significant. Postoperative hospitalization period was shorter in group 3 (3.19 ± 2.2 days) compared with group 1 (4.12 ± 2.4 days; p < .001) but not to that of group 2 (3.44 ± 2.8 days; p = .680). Postoperative pain score was lower in group 3 (3.24 ± 1.1) compared with both group 1 (6.36 ± 1.7; p < .001) and group 2 (4.85 ± 1.1; p < .001). Urine leakage complication was lower in group 3 (0.4%) compared with group 1 (2.9%, p = .038) but not to that of group 2 (0.5%; p = .897).

Conclusions: Tubeless PCNL is effective and safe for uncomplicated PCNL in the absence of residual stones. Tubeless PCNL with EUC is associated with decreased pain, hospitalization time, and urine leakage compared with standard PCNL. However, it is only associated with decreased pain when compared with tubeless PCNL with DJ stent.


References

Moosanejad N, Firouzian A, Hashemi SA, Bahari M, Fazli M. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: A randomized, clinical trial. Brazilian J Med Biol Res. 2016;49:1–6.

Choi SW, Kim KS, Kim JH, et al. Totally tubeless versus standard percutaneous nephrolithotomy for renal stones: analysis of clinical outcomes and cost. J Endourol. 2014;28:1487–94.

Aghamir SMK, Salavati A, Hamidi M, FallahNejad A. Primary Report of Totally Tubeless Percutaneous Nephrolithotomy Despite Pelvi-calyceal Perforations. Urol J. 2017;14:4020–3.

Lee JY, Jeh SU, Kim MD, et al. Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: A systematic review and network meta-analysis of 16 randomized controlled trials. BMC Urol. 2017;17:1–16.

Zhong Q, Zheng C, Mo J, Piao Y, Zhou Y, Jiang Q. Total Tubeless Versus Standard Percutaneous Nephrolithotomy: A Meta-Analysis. J Endourol. 2013;27:420–6.

Mishra S, Sabnis RB, Kurien A, Ganpule A, Muthu V, Desai M. Questioning the wisdom of tubeless percutaneous nephrolithotomy (PCNL): A prospective randomized controlled study of early tube removal vs tubeless PCNL. BJU Int. 2010;106:1045–8.

Amer T, Ahmed K, Bultitude M, et al. Standard versus tubeless percutaneous nephrolithotomy: A systematic review. Urol Int. 2012;88:373–82.

Bellman GC, Davidoff R, Candela J, Gerspach J, Kurtz S, Stout L. Tubeless percutaneous renal surgery. J Urol. 1997;157:1578–82.

Yuan H, Zheng S, Liu L, Han P, Wang J, Wei Q. The efficacy and safety of tubeless percutaneous nephrolithotomy: A systematic review and meta-analysis. Urol Res. 2011;39:401–10.

Singh G, Hota D, Panda S, Swain S, Mohanty PK. Pd16-09 Externalized Ureteral Catheter Versus Double J Stenting in Tubeless Percutaneous Nephrolithotomy: a Prospective, Randomized Study. J Urol. 2017;197:e351.

Chen Y, Feng J, Yue Y, et al. Externalized Ureteral Catheter Versus Double-J Stent in Tubeless Percutaneous Nephrolithotomy for Upper Urinary Stones: A Systematic Review and Meta-Analysis. J Endourol. 2018;32:581–8.

Gonen M, Ozturk B, Ozkardes H. Double-J Stenting Compared with One Night Externalized Ureteral Catheter Placement in Tubeless Percutaneous Nephrolithotomy. J Endourol. 2009;23:27–31.

Goh M, Wolf JS. Almost totally tubeless percutaneous nephrolithotomy: further evolution of the technique. J Endourol. 1999 Apr;13:177–80.

Telha KA, Alba’adani TH, Alkohlany KM, Al-Adimy AO, Alnono IH. Tubeless percutaneous nephrolithotomy with double-J stent compared with external ureteral catheter to decrease postoperative complications. Saudi Med J. 2010;31:1137–40.

Ko R, Soucy F, Denstedt JD, Razvi H. Percutaneous nephrolithotomy made easier: A practical guide, tips and tricks. BJU Int. 2008;101:535–9.

Radfar MH, Basiri A, Nouralizadeh A, et al. Comparing the Efficacy and Safety of Ultrasonic Versus Pneumatic Lithotripsy in Percutaneous Nephrolithotomy: A Randomized Clinical Trial. Eur Urol Focus. 2017;3:82–8.

Sebaey A, Khalil MM, Soliman T, et al. Standard versus tubeless mini-percutaneous nephrolithotomy: A randomised controlled trial. Arab J Urol. 2016;14:18–23.

Bhat S, Lal J, Paul F. A randomized controlled study comparing the standard, tubeless, and totally tubeless percutaneous nephrolithotomy procedures for renal stones from a tertiary care hospital. Indian J Urol. 2017;33:310.

Wickham JEA, Miller RA, Kellet MJ, Payne SR. Percutaneous Nephrolithotomy: One Stage or Two? Br J Urol. 1984;56:582–5.

Basiri A, Kashi AH, Zeinali M, Nasiri MR, Valipour R, Sarhangnejad R. Limitations of Spinal Anesthesia for Patient and Surgeon During Percutaneous Nephrolithotomy. Urol J. 2018;15:164–7.

Solakhan M, Bulut E, Erturhan MS. Comparison of Two Different Anesthesia Methods in Patients Undergoing Percutaneous Nephrolithotomy. Urol J. 2019;16:246–50.

Xun Y, Wang Q, Hu H, et al. Tubeless versus standard percutaneous nephrolithotomy: An update meta-analysis. BMC Urol. 2017;17:1–17.

Damiano R, Oliva A, Esposito C, De Sio M, Autorino R, D’Armiento M. Early and late complications of double pigtail ureteral stent. Urol Int. 2002;69:136–40.

Maghsoudi R, Etemadian M, Kashi AH, Ranjbaran A. The Association of Stone Opacity in Plain Radiography with Percutaneous Nephrolithotomy Outcomes and Complications. Urol J. 2016;13:2899–902.

Borges CF, Fregonesi A, Silva DC, Sasse AD, Sasse D, Ph D. Systematic Review and Meta-Analysis of Nephrostomy Placement Versus Tubeless Percutaneous Nephrolithotomy. J Endourol. 2010;24:1739–46.

Mandhani A, Goyal R, Vijjan V, Dubey D, Kapoor R. Tubeless Percutaneous Nephrolithotomy-Should a Stent be an Integral Part? J Urol. 2007;178:921–4.

Maghsoudi R, Farhadi-Niaki S, Etemadian M, et al. Comparing the Efficacy of Tolterodine and Gabapentin Versus Placebo in Catheter Related Bladder Discomfort After Percutaneous Nephrolithotomy: A Randomized Clinical Trial. J Endourol. 2017;32:168–74.

Xiong J, Xiang C, Chengwei W, Shuqun L, Li J. Intra-operative Oxycodone Reduced Postoperative Catheter-Related Bladder Discomfort Undergoing Transurethral Resection Prostate. A Prospective, Double Blind Randomized Study. Urol J. 2019. [Epub ahead of print]




DOI: http://dx.doi.org/10.22037/uj.v0i0.5280

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