RESEARCH ARTICLE


Tubeless Percutaneous Nephrolithotomy: Can be a Choice, Why Not?



Mert Ali Karadag* , 1, Kursat Cecen1, Aslan Demir1, Ramazan Kocaaslan1, Kerem Taken2, Fatih Altunrende3
1 Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey
2 Yuzuncuyil University Faculty of Medicine, Department of Urology, Van, Turkey
3 Bilim University Faculty of Medicine, Department of Urology, Istanbul, Turkey


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open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey; Tel: +90 532 558 43 24; karadagmert@yahoo.com


Abstract

Percutaneous nephrolithotomy (PCNL) has been widely accepted and is commonly used to treat renal calculi. The optimal drainage of kidney after PCNL has not been clearly determined yet. Placement of an 18F to 24F nephrostomy tube at the end of the procedure is accepted as standard of care to date. The main advantages are adequate renal drainage, hemostatic tamponade and providing renal access for second look PCNL. However, based on the concept that the purpose of the tube is only to maintain adequate drainage of the kidney, a “tubeless” approach has been developed by placing a ureteral stent or catheter to provide drainage after PCNL instead of a nephrostomy tube. Tubeless PCNL is an effective and safe procedure for treatment of renal stones in selected cases. This procedure can even be chosen for patients with previous renal surgery, and hemorrhagic tendency. By using this method, less postoperative pain and a shorter hospital stay can be achieved, when compared with conventional PCNL. There is a controversy over ideal drainage system after PCNL in recent years. Herein, we made a systematic review for efficacy and safety of tubeless PCNL, totally tubeless PCNL, discussed different variations and compared the outcomes of this technique with standart PCNL.

Keywords : Complications, percutaneous renal surgery, renal stones, totally tubeless, tubeless percutaneous nephrolithotomy, urolithiasis.