Comparing Totally Tubeless and Tubeless Percutaneous Nephrolithotomy with Standard Techniques

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithiasis Management

Background:

• Traditional percutaneous nephrolithotomy (PCNL) involves nephrostomy tubes and Double J (DJ) stents for drainage.
• Tubeless and totally tubeless PCNL techniques aim to eliminate or reduce the need for these drainage methods.

Purpose of the Study:

• To evaluate the feasibility, safety, and effectiveness of tubeless and totally tubeless PCNL compared to standard PCNL.
• To assess patient outcomes, including operative time, pain, analgesic requirements, hospital stay, and complication rates.

Main Methods:

• Retrospective analysis of 156 patients undergoing PCNL from September 2022 to September 2023.
• Patients were divided into three groups: standard PCNL (n=78), tubeless PCNL (n=46), and totally tubeless PCNL (n=32).
• Comparison of preoperative characteristics, operative parameters, stone clearance, and complication rates across the groups.

Main Results:

• Tubeless and totally tubeless PCNL groups had significantly lower operation times, analgesic requirements, and hospital stays (p<0.05).
• No significant differences were observed in mean stone size, stone-free status, or major complications.
• Overall complication rates were 14.2% for standard PCNL, 8.7% for tubeless PCNL, and 9.4% for totally tubeless PCNL.

Conclusions:

• Tubeless and totally tubeless PCNL are safe and effective, even for complex stone burdens.
• These techniques lead to reduced pain, shorter procedures, and decreased hospital stays, enhancing cost-effectiveness and patient satisfaction.
• Further research is recommended to support wider adoption in clinical practice.