OBJECTIVES: To evaluate the safety, effectiveness, and feasibility of totally (tubeless and stentless) tubeless percutaneous nephrolithotomy (PCNL) in elderly patients. Tubeless PCNL is performed widely in adult patients. METHODS: A total of 60 patients with renal stones were enrolled in this study. Patients were randomized to either a totally tubeless approach (group 1, 30 patients) or placement of an 18F nephrostomy tube (group 2, 30 patients). Patients were considered uncomplicated and suitable for randomization at the end of the operation if there was no significant bleeding or residual stone, and the pelvicaliceal system was intact. The incidence of complications, hospital stay, analgesic requirements, and stone-free rates were compared in 2 groups. RESULTS: The mean age of the patients at receipt of the surgical procedure was 67.7 years (range, 60-77) vs 66.5 years (range, 61-74), respectively. The mean stone size was 25.6 vs 22.3 mm and stone-free rate was 86% vs 83% for group 1 and 2, respectively (P > .05). The mean hospitalization time was 1.5 and 3.2 days (P < .001), the mean analgesia requirement (pethidine HCl) was 0.5 and 1.4 mg/kg, respectively (P < .01). Decrease in hematocrit was similar in 2 groups. No blood transfusions were needed. CONCLUSIONS:Totally tubeless PCNL is safe and effective procedure even in elderly patients with renal stones. The hospitalization and analgesic requirements are less than standard PCNL. However, the tubeless decision should be taken intraoperatively in selected patients. Copyright (c) 2010 Elsevier Inc. All rights reserved.
RCT Entities:
OBJECTIVES: To evaluate the safety, effectiveness, and feasibility of totally (tubeless and stentless) tubeless percutaneous nephrolithotomy (PCNL) in elderly patients. Tubeless PCNL is performed widely in adult patients. METHODS: A total of 60 patients with renal stones were enrolled in this study. Patients were randomized to either a totally tubeless approach (group 1, 30 patients) or placement of an 18F nephrostomy tube (group 2, 30 patients). Patients were considered uncomplicated and suitable for randomization at the end of the operation if there was no significant bleeding or residual stone, and the pelvicaliceal system was intact. The incidence of complications, hospital stay, analgesic requirements, and stone-free rates were compared in 2 groups. RESULTS: The mean age of the patients at receipt of the surgical procedure was 67.7 years (range, 60-77) vs 66.5 years (range, 61-74), respectively. The mean stone size was 25.6 vs 22.3 mm and stone-free rate was 86% vs 83% for group 1 and 2, respectively (P > .05). The mean hospitalization time was 1.5 and 3.2 days (P < .001), the mean analgesia requirement (pethidine HCl) was 0.5 and 1.4 mg/kg, respectively (P < .01). Decrease in hematocrit was similar in 2 groups. No blood transfusions were needed. CONCLUSIONS: Totally tubeless PCNL is safe and effective procedure even in elderly patients with renal stones. The hospitalization and analgesic requirements are less than standard PCNL. However, the tubeless decision should be taken intraoperatively in selected patients. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Authors: Tanja Hüsch; Michael Reiter; René Mager; Eva Steiner; Thomas R W Herrmann; Axel Haferkamp; David Schilling Journal: World J Urol Date: 2015-04-23 Impact factor: 4.226
Authors: Luigi Cormio; Gaspar Ibarlucea Gonzalez; David Tolley; Mario Sofer; Ahmet Muslumanoglu; Hans-Christoph Klingler; Jens-Uwe Stolzenburg; Jean de la Rosette Journal: World J Urol Date: 2012-07-01 Impact factor: 4.226