Safety and efficacy of tubeless percutaneous nephrostolithotomy.

The experience at this institution with tubeless percutaneous nephrostolithotomy was reviewed to determine its safety and efficacy. Between April 1997 and June 1998, 33 "tubeless" percutaneous nephrostolithotomies were performed. All procedures were performed by a single surgeon (R.W.W). All patients had an internal ureteral stent placed at the time of surgery, and a Foley catheter remained in place overnight. All patients had their nephrostomy tube removed in the OR at the end of their surgery. The length of hospitalization, operative time, patients' comorbid conditions, pre- and postoperative hematocrits, transfusion requirements, reasons for a stay of longer than 24 h, complications, stone burdens treated, residual stone disease, any additional procedures required, and postoperative analgesia requirements were reviewed. All 33 percutaneous procedures were performed without significant complication. No transfusion was required. The average length of hospital stay was 1.5 days, with two-thirds of patients staying less than 24 h. A 94% stone-free rate was achieved, and patients had minimal analgesia requirements. This experience with the "tubeless" percutaneous nephrostolithotomy indicates that it is a safe and effective means of stone management. It will likely have an expanding role in the treatment of stone disease and other urologic problems of the upper urinary tract.