Comparison of tubeless and standart percutaneous nephrolitotomy procedures performed selected patient population with renal stones

Aim in the study: We aimed to compare percutaneous nephrolitotomy(PNL) with tube or tubeless techniques which are minimal invasive surgery techniques that used for kidney stone disease treatment. History of stone in other kidney, history of ESWL and past surgery, stone size, grade of hydronephrosis, operation time, scopy time, hospitalization lenght after the surgery, success of surgery, hemoglobine and creatinine changes before and after surgery, post operative pain score and analgesic necessity, complications of surgery were used as comparison criterias. Patients and Methods: 68 patients undergoing unilateral PNL were included in the study. 34 of them were tubeless. Pre operative examinations, surgery positions and techniques, anesthesia protocols were same for all of the patients. Patients undergoing PNL with or without tube compared with criterias of stone history in other kidney, history of ESWL and past surgery, stone size, grade of hydronephrosis, amplatz dilatation grade, operation time, scopy time, hospitalization lenght after the surgery, success of surgery, hemoglobine and creatinine changes before and after surgery, post operative pain score and analgesic necessity, complications after surgery. Results: There was no statistically significant difference between the two groups in terms of gender, age, stone in other kidney, history of ESWL and number of past ESWL sessions, history of past open surgeries and PNL's, stone size and localization, grade of hydronephrosis, operation side, pole of access, staying time of ureteral catheter, hemoglobine and creatinine changes before and after surgery, complications, prolonged drainage, pre or post operatively necessity of DJ stent, need for re-PNL. Amplatz dilatation grade, operation time, scopy time, pneumatic lithotripter hit count, hospitalization lenght after the surgery, post operative pain score and analgesic necessity were found lower in the tubeless group. Conclusion: Our study showed that tubeless PNL can be performed smoothly in cases with high amount of kidney stone, with or without hydronephrosis, if the patient has an intact collecting system, has no edema at ureteropelvic junction, has no serious bleeding pre operatively and is considered stone free at the end of surgery. Keywords: Stone disease, tubeless PNL, nephrostomy tube