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Tubeless percutaneous nephrolithotomy: outcomes with expanded indications.

Wahib Isac1, Emad Rizkala1, Xiaobo Liu1

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Tubeless percutaneous nephrolithotomy (PCNL) offers shorter hospital stays and less postoperative pain compared to standard PCNL. This approach is safe and effective for all patients, regardless of intraoperative complications.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithotomy

Background:

  • Tubeless percutaneous nephrolithotomy (PCNL) aims to reduce hospital stay and postoperative pain.
  • Previous studies often excluded patients with complications, limiting tubeless PCNL's evaluated utility.
  • This study assesses tubeless PCNL in all patients, irrespective of intraoperative outcomes.

Purpose of the Study:

  • To evaluate the effectiveness and safety of tubeless percutaneous nephrolithotomy (PCNL) in all patients.
  • To compare outcomes of tubeless PCNL versus standard PCNL, including those with intraoperative complications.

Main Methods:

  • Retrospective chart review of 159 patients undergoing PCNL.
  • Patients were divided into tubeless PCNL (n=83) and standard PCNL (n=76) groups.
  • Demographics, operative, and postoperative outcomes were compared between groups.

Main Results:

  • Tubeless PCNL group had fewer access tracts and shorter hospital stays (1.7 vs. 3.0 days).
  • No significant difference in complication rates between tubeless and standard PCNL groups.
  • Multivariable analysis confirmed tubeless PCNL is associated with shorter hospital stay and less pain.

Conclusions:

  • Tubeless PCNL is confirmed to provide shorter hospital stays and reduced postoperative pain.
  • The safety of tubeless PCNL is established, even in the presence of intraoperative bleeding or other complications.
  • This approach is viable for all patients undergoing PCNL, expanding its clinical application.