The comparison of oxidative stress effect in classic and tubeless percutaneous nephrolithotomy

Surgical stone treatment induces oxidative stress in kidney tissue. We hypothesized that tubeless percutaneous nephrolithotomy (tPCNL) may induce less oxidative stress than classic percutaneous nephrolithotomy (cPCNL) with nephrostomy tube.

Seventy-two consecutive patients with kidney stones qualified for PCNL were enrolled in the study. Patients were assigned to one of two groups (first group 33 patients-cPCNL and second group 39 patients-tPCNL). Four urine samples were collected in four consecutive days, starting the day before operation. Four oxidative stress markers were analyzed in each sample: catalase (CAT), protein sulfhydryl group (SH), total antioxidant capacity (TAC) and superoxide dismutase (SOD).

Baseline mean levels of CAT (IU/l), SH (μmol/l), TAC (mmol/l) and SOD (NU/ml) were 19.4 versus 11.7; 18 versus 58.7; 2.02 versus 1.99; 20.5 versus 22.6 in cPCNL and tPCNL group, respectively. On day two, the levels were 89 versus 104.9; 334.7 versus 518.9; 1.87 versus 1.79; 33.7 versus 41.4, respectively. On the third day, the levels were: 67.4 versus 28.3; 206.8 versus 306.9; 2.01 versus 2.06; 38.2 versus 36.6, respectively. On the fourth day, the concentrations were 47.4 versus 18.5; 129.3 versus 208.7; 2 versus 2.06; 35 versus 45.2, respectively. Significant differences were observed only for CAT and TAC concentrations in days 3 (p = 0.04 and 0.04) and 4 (p = 0.02 and < 0.001) in favor of tPCNL.

CAT, SH and SOD significantly rise after operation. TAC represents the inversion of other parameters. CAT is significantly lower, and TAC is significantly higher in tPCNL postoperatively favoring this method.