Are Nephrostomy and Ureteral Stent Necessary After Multi-Access Percutaneous Nephrolithotomy? Publisher



Aghamir SMK¹ ; Heidari R¹ ; Bayesh S² ; Salavati A¹ ; Elmimehr R¹ Show Affiliations
Source: Current Urology Published:2019

Abstract

Introduction: Totally tubeless percutaneous nephrolithotomy (PCNL) is a well-established technique used in single -access procedure nevertheless these results challenge the multi-access PCNL as a contra-indication to application of this technique. Aims: To compare complication rates and safety of use of this technique after multi-access PCNL. Methods: A Total of 130 patients with renal stones were enrolled in this cohort study. Totally tubeless PCNL with single access (Group A, n = 70) and multi-access (Group B, n = 60) were done and bleedings were assessed by measuring hemoglobin (Hb) drop, blood transfusion rate and need for angioembolization besides leakage rates which were also recorded. Results: In the 130 patients who underwent totally tubeless PCNL, no leakage from puncture site nor angioembolization cases were identified. There was no significant statistical differences between 2 groups regarding Hb drop (1.91 in single access versus 2.20 in multi-access), transfusion rate and length of hospital stay (p > 0.05). Stone-free rate was increased from 91% in single access to 97% in multi access by adding percutaneous access sites (from 91% in single access to 97% in multi-access). Conclusions: Multi-access totally tubeless PCNL seems feasible and has comparable complication rates including Hb drop besides providing the advantage of higher stone-free rates using multi-access tracts. © 2019 S. Karger AG, Basel.