Parsa Nikoufar, Amr Hodhod, Ruba Abdul Hadi, Loay Abbas, Sai K. Vangala, A. Zakaria, M. Gawish, Amer Alaref, R. Rozenberg, H. Elmansy
Introduction: This study aimed to assess the safety and efficacy of ambulatory mini-percutaneous nephrolithotomy (mini-PCNL) in a totally tubeless exit (without a nephrostomy tube or an internal stent) and tubeless exit (without a nephrostomy tube but with an internal stent) for the treatment of renal calculi 10–25 mm in size. Methods: We conducted a retrospective analysis of patients who underwent mini-PCNL at our institution between September 2018 and September 2022. The study included a cohort of 95 patients diagnosed with renal calculi measuring 10–25 mm. All patients underwent a computed tomography (CT) renal colic scan preoperatively, on postoperative day one (POD 1), and at three-month followup. Patient demographics and outcome parameters were recorded, including stone characteristics, operative time, hospital stay, stone-free rate (SFR), complication rates, and subsequent emergency room (ER) visits. Patients were considered stone-free if they had no fragments or residual fragments measuring <4 mm. Results: The median maximum stone diameter was 16 mm (10–25 mm). Twenty-nine patients (30.5%) had multiple renal calculi. The median operative time was 64 (38–135) minutes. Eighty-six patients (90.5%) underwent a totally tubeless procedure, without a nephrostomy tube or an internal stent. All patients were discharged home on the same operative day with a median hospitalization time of six hours. Seven (7.4%) postoperative ER visits were recorded, and two (2.1%) led to hospital readmission. The frequency of grade I, II, and III Clavien-Dindo complications were 18 (18.9%), one (1.1%), and one (1.1%), respectively. The SFR on POD 1 and three-month followup was 73.7% and 92.6%, respectively. None of the patients in the study required retreatment. Conclusions: Ambulatory tubeless mini-PCNL is a safe and effective treatment option for 10–25 mm renal stones. Experienced institutions can safely adopt ambulatory mini-PCNL as a treatment option without an increased risk of postoperative complications, ER visits, or hospital readmissions.
{"title":"Safety and efficacy of ambulatory tubeless mini-percutaneous nephrolithotomy in the management of 10–25-mm renal calculi","authors":"Parsa Nikoufar, Amr Hodhod, Ruba Abdul Hadi, Loay Abbas, Sai K. Vangala, A. Zakaria, M. Gawish, Amer Alaref, R. Rozenberg, H. Elmansy","doi":"10.5489/cuaj.8764","DOIUrl":"https://doi.org/10.5489/cuaj.8764","url":null,"abstract":"Introduction: This study aimed to assess the safety and efficacy of ambulatory mini-percutaneous nephrolithotomy (mini-PCNL) in a totally tubeless exit (without a nephrostomy tube or an internal stent) and tubeless exit (without a nephrostomy tube but with an internal stent) for the treatment of renal calculi 10–25 mm in size.\u0000Methods: We conducted a retrospective analysis of patients who underwent mini-PCNL at our institution between September 2018 and September 2022. The study included a cohort of 95 patients diagnosed with renal calculi measuring 10–25 mm. All patients underwent a computed tomography (CT) renal colic scan preoperatively, on postoperative day one (POD 1), and at three-month followup. Patient demographics and outcome parameters were recorded, including stone characteristics, operative time, hospital stay, stone-free rate (SFR), complication rates, and subsequent emergency room (ER) visits. Patients were considered stone-free if they had no fragments or residual fragments measuring <4 mm.\u0000Results: The median maximum stone diameter was 16 mm (10–25 mm). Twenty-nine patients (30.5%) had multiple renal calculi. The median operative time was 64 (38–135) minutes. Eighty-six patients (90.5%) underwent a totally tubeless procedure, without a nephrostomy tube or an internal stent. All patients were discharged home on the same operative day with a median hospitalization time of six hours. Seven (7.4%) postoperative ER visits were recorded, and two (2.1%) led to hospital readmission. The frequency of grade I, II, and III Clavien-Dindo complications were 18 (18.9%), one (1.1%), and one (1.1%), respectively. The SFR on POD 1 and three-month followup was 73.7% and 92.6%, respectively. None of the patients in the study required retreatment.\u0000Conclusions: Ambulatory tubeless mini-PCNL is a safe and effective treatment option for 10–25 mm renal stones. Experienced institutions can safely adopt ambulatory mini-PCNL as a treatment option without an increased risk of postoperative complications, ER visits, or hospital readmissions.","PeriodicalId":38001,"journal":{"name":"Canadian Urological Association Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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