[DRAINLESS TRANSCUTANEOUS NEPHROLITHOTRIPSY. OUR FIRST EXPERIENCE].

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Transcutaneous nephrolithotripsy (DTN) is a common procedure for renal calculi.
• The use of nephrostomic drains post-DTN can lead to increased patient discomfort and prolonged recovery.
• Exploring drainless techniques aims to improve patient outcomes and reduce morbidity.

Purpose of the Study:

• To summarize the experience and outcomes of performing drainless transcutaneous nephrolithotripsy (DTN).
• To evaluate the safety and efficacy of DTN without a nephrostomic drain compared to traditional methods.
• To identify patient selection criteria and procedural nuances for successful drainless DTN.

Main Methods:

• A retrospective summary of 245 patients undergoing mini-DTN for renal concrements.
• Comparison between patients with (n=224) and without (n=21) a nephrostomic drain.
• In drainless cases, antegrade ureteric JJ-stent placement was utilized.
• Indications, patient selection, and procedural details of DTN were analyzed.

Main Results:

• Out of 245 patients, 21 (8.6%) were treated with drainless DTN, while 224 (91.4%) had a nephrostomic drain.
• JJ-stents were removed between postoperative days 2-7, with some removals in an ambulatory setting.
• Patients without a nephrostomic drain required anesthesia significantly less often post-operatively.
• Drainless DTN demonstrated reduced pain syndrome severity in the early postoperative period.

Conclusions:

• Drainless transcutaneous nephrolithotripsy (DTN) is a secure and effective procedure for managing renal stones.
• The technique, when performed by experienced surgeons adhering to strict criteria, can significantly reduce postoperative pain and discomfort.
• This approach offers a promising alternative for select patients, potentially improving early recovery and patient satisfaction.