A Report on Safety Analysis of Tubeless Percutaneous Nephrolithotomy

The objective is to evaluate clinical indications and safety of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of stones in upper urinary tract. A total of 231 subjects accepted to undergo tubeless PCNL, both micro-channel and standard operation were performed. After PCNL, renal gastrostomy tube was not placed also catheters and double-J stents were subsequently removed 3-5 and 14-28 days, respectively. Primary PCNL resulted in stone clearance of 98.27 %. There were five cases of postoperative hemorrhage with bleeding of about 500 ml, which was stopped by keeping patients in bed and medication. Three cases had pleural injury and thoracentesis plus drainage was performed in one case. Other two cases did not receive any special treatment due to a small amount of pleural effusion. No urinary leakage, perineal hematoma, infection, and other complications were observed in both of these cases. One and three months check-ups after discharge showed no recurrence of stones or perineal urinoma, and hydronephrosis were relieved in varying degrees. Thus, the application of tubeless PCNL is a safe and effective procedure for upper urinary tract calculi and the presence of stones was confirmed during operation showing good location with double-J stent and no obvious bleeding or damage.