Is Totally Tubeless Percutaneous Nephrolithotomy a Safe and Efficacious Option for Complex Stone Disease?
Nir Tomer1, Vinay Durbhakula1, Kavita Gupta1
1Department of Urology, Icahn School of Medicine at Mount Sinai, 425 W. 59th Street, Suite 4F, New York, NY 10019, USA.
Journal of Clinical Medicine
|June 19, 2024
Summary
Totally tubeless percutaneous nephrolithotomy (tt-PCNL) offers improved outcomes without increased complications compared to traditional methods. This technique shortens hospital stays and reduces post-operative pain for kidney stone patients.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Percutaneous nephrolithotomy (PCNL) is standard for large kidney stones.
- Traditional PCNL often involves nephrostomy tubes or ureteral stents.
- Totally tubeless PCNL (tt-PCNL) omits post-operative tubes.
Purpose of the Study:
- To review literature on tt-PCNL outcomes and complications.
- To discuss tt-PCNL technique and implementation.
- To compare tt-PCNL with traditional PCNL approaches.
Main Methods:
- Comprehensive literature search of MEDLINE database.
- Inclusion of review articles, meta-analyses, systematic reviews, and primary research.
- Analysis of peri-operative and post-operative outcomes, and complications.
Main Results:
- tt-PCNL shows similar complication rates to traditional PCNL.
- tt-PCNL results in significantly shorter hospital stays (mean 1.96 days shorter).
- tt-PCNL is associated with decreased post-operative pain and analgesic needs.
Conclusions:
- tt-PCNL is a safe and feasible technique for selected patients.
- tt-PCNL offers improved post-operative outcomes.
- tt-PCNL is recommended for centers not currently using the procedure.
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