Tubeles Spercutaneous Nephrolithotomy (PCNL) Post-operative Complication Comparison Between Stent and Stentless in Tubeless PCNL
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Abstract
Background: Kidney stones are a common problem in the Northeast of Thailand. eventually leading to urinary tract infections and kidney failure. The main treatment for large kidney stones is PCNL. A DJ stent (Tubeless PCNL) is commonly used to drain urine to prevent obstruction after surgery. This study compared safety in patients undergoing surgery without a DJ stent after surgery (stentless in tubeless PCNL).
Objective: To compare the complications of PCNL surgery between DJ stent insertion after surgery and no DJ stent insertion.
Methods: This is a retrospective cohort study of patients who underwent PCNL surgery from July 2012-May 2020 at Sisaket Hospital. All surgeries were performed the same way as Standard PCNL, prone position and pneumatic lithotripsy.This study was comparison between two groups, tubeless PCNL and stentless in tubeless PCNL. Exclusion criteria are those at risk of infection or renal failure, have a high residual stone, or have an endopyelotomy. The study will look at postoperative conditions such as length of stay in hospital, blood transfusion, fever from infection, postoperative hemorrhage, pleuraleffusion, and stone migration.
Results: Two hundred and eightpatients underwent stentless in tubeless PCNL, or 43.9%, were in the range of age between 24-82 years. When comparing complications of PCNL, there was no difference between a DJ stent and without a DJ stent. Whether it was hospital stay (p-value = 0.183), fever from infection after surgery (p-value=0.082),blood transfusion (p-value=0.528),postoperative bleeding (p-value=0.638), pleural effusion (p-value=0.69), and stone migration (p-value=0.056).
Conclusion: Stentless in tubeless PCNL surgery complications would not different from tubeless PCNL. It could also reduce problems caused by DJ stent, such as pain from DJ stent, hematuria, stone encrusted, and the most worrying thing is that patients do not come to remove the DJ stent, which will lead to more complications.
Keywords: Tubeless PCNL, stentless PCNL, Renal stone, Complications
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References
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