دورية أكاديمية
Totally Tubeless Percutaneous Nephrolithotomy.
| العنوان: | Totally Tubeless Percutaneous Nephrolithotomy. |
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| المؤلفون: | Tim J. Crook, C.R. Lockyer, Stephen R Keoghane, Byron H. Walmsley |
| المصدر: | Journal of Endourology; Feb2008, Vol. 22 Issue 2, p267-272, 6p |
| مصطلحات موضوعية: | KIDNEY surgery, KIDNEY stones, THERAPEUTICS, HOSPITAL care |
| مستخلص: | PurposeTo establish if totally tubeless percutaneous nephrolithotomy (PCNL) is a safe management technique. PCNL is a well-established option for upper tract stones. The procedure traditionally concludes with the placement of a nephrostomy drainage tube but in those patients in whom there has been minimal blood loss and complete stone clearance, it may not be necessary to place a nephrostomy.Patients and MethodsTotally tubeless PCNL was performed in uncomplicated cases, when there was no significant bleeding or residual stone load, an intact pelvicaliceal system, and no evidence of a residual ureteral stone.Results100 procedures were analyzed during a 10-year period from 1996 to 2006. The mean stone size was 15.9 mm (range 740 mm). Mean residual stone load was 1.74 mm (range 110 mm). Access was considered difficult in 2. Transfusion rate was 1 with a mean fall in hemoglobin of 1.4 gdL ([0.4] [5.6] gdL), and a mean rise in creatinine level of 0.3 molL ([43] [52] molL). The minor sepsis rate was 5, and the major sepsis rate was 1. The readmission rate was 1. The mean length of stay was 2.9 days (range 110 d). Secondary treatment was required in 5, and stone clearance rate at 3 months was 90.ConclusionThis study demonstrates that PCNL without nephrostomy or stent is a safe and well-tolerated procedure in selected patients. It is the authors' belief that totally tubeless PCNL may be considered an accepted standard of care for selected patients, and it is possible to reserve placement of a nephrostomy tube or internal ureteral stent for specific indications. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: | Complementary Index |
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