Outcomes of Percutaneous Nephrolithotripsy With or Without Nephrostomy Tube: A Comparative Study

N. M. Shrestha
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Abstract

Introduction: Percutaneous Nephrolithotripsy (PCNL) is one of the most accepted surgical modality for removal of renal stone. Placement of a nephrostomy tube at the end of PCNL is a standard procedure for PCNL, however many reports have showed the safety and efficacy of tubeless PCNL for the removal of renal stone. Aims: The present study aimed to report the outcomes of PCNL with or without nephrostomy tube. Methods: It is Prospective Hospital Study conducted from June 2017 to April 2020 in the Department of Urology Nepalgunj Medical College. Total 153 patients under inclusion criteria were divided into two groups. Group 1 (75 patients) was allocated to patients who were   being treated under standard PCNL procedure while Group 2 (78 patients) was allocated for patients who were being treated under Tubeless PCNL procedure. The two groups were compared for operation time (minutes), hospital stay (days), post operative dose of analgesic (mg), post operative complications such as, leakage (%), bleeding (%) and infection (%). Data were analyzed from SPSS and p-value less than 0.5 was considered as significant. Results: In Group II the mean hospital stay, analgesic dose and rate of leakage was significantly lesser than Group I (p<0.05) whereas, the mean operation time, rate of infection and bleeding were not significantly different between two groups (p>0.05). Conclusion:  Tubeless PCNL procedure causes more rapid recovery and earlier discharge from the hospital, reduction in postoperative pain and no leakage when compared to standard tubless PCNL.
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经皮肾镜碎石术伴或不伴肾造口管的疗效比较研究
导读:经皮肾镜碎石术(PCNL)是最被接受的肾结石切除手术方式之一。在PCNL末端放置肾造瘘管是PCNL的标准程序,然而许多报告显示无管PCNL用于去除肾结石的安全性和有效性。目的:本研究旨在报道PCNL合并或不合并肾造口管的结果。方法:于2017年6月至2020年4月在尼泊尔医学院泌尿外科进行前瞻性医院研究。153例符合纳入标准的患者分为两组。组1(75例)分配给采用标准PCNL治疗的患者,组2(78例)分配给采用无管PCNL治疗的患者。比较两组患者手术时间(分钟)、住院时间(天)、术后镇痛药剂量(mg)、术后并发症(漏液%、出血%、感染%)。数据采用SPSS分析,p值小于0.5为显著性。结果:ⅱ组患者平均住院时间、镇痛剂量、漏药率均显著低于ⅰ组(p0.05)。结论:与标准无管PCNL相比,无管PCNL术恢复快,出院早,术后疼痛减轻,无渗漏。
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