A Comparison of Standard Percutaneous Nephrolithotomy and Tubeless Percutaneous Nephrolithotomy: Does Tubeless Realy Superior? A Prospective Randomized Double-Blind Study

Abstract

Aim: We aimed to compare patient groups who underwent either a standard percutaneous nephrolithotomy (PNL) or tubeless PNL for safety, effectiveness and patient comfort. Material and Methods: 78 patients were included in the study. Patients who underwent the standard PNL (n=38) or tubeless PNL (n=40) were randomized into Groups 1 and 2, respectively. This study was designed as a prospective, randomized, double-blind investigation. Patients who had active bleeding at the end of the operation and those with multiple access tracts were excluded from the study. To evaluate postoperative pain and complications, a visual analogue scale (VAS) and a modified Clavien classification were used, respectively. Results: A statistically significant difference was not found between the two patient groups for demographic data (age and gender), or for size, laterality, and intrarenal location of the stone(s) (p>0.05). Perioperative data, including operative and fluoroscopy times and stone‑free rates, perioperative changes in creatinine and haemoglobin values, blood transfusion, VAS 2 to 3 pain scores, analgesic requirements, fever and complications requiring additional surgical treatment were not statistically different between groups (p>0.05). A VAS 1 pain score and hospital stays were significantly decreased in the tubeless PNL group (p=0.003). Conclusions: Tubeless PNL surgery is an effective and safe endourological procedure that can be performed by experienced surgeons. Its advantages over standard PNL include less pain during the early postoperative period, shorter hospital stays but the rates of complications are not significantly lower.

Keywords

• renal stones
• percutaneous nephrolithotomy
• standard pnl
• tubeless pnl
• pain
• hospitalization time