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Intraoperative patient selection for tubeless percutaneous nephrolithotomy

Authors
 Joo Yong Lee  ;  Kyu Hyun Kim  ;  Man Deuk Kim  ;  Doo Yong Chung  ;  Kang Su Cho 
Citation
 INTERNATIONAL SURGERY, Vol.99(5) : 662-668, 2014 
Journal Title
 INTERNATIONAL SURGERY 
ISSN
 0020-8868 
Issue Date
2014
MeSH
Algorithms ; Databases, Factual ; Decision Making ; Female ; Hemoglobins/analysis ; Humans ; Intraoperative Period ; Length of Stay ; Male ; Middle Aged ; Nephrostomy, Percutaneous/methods* ; Pain Measurement ; Patient Selection*
Keywords
Patient selection ; Percutaneous nephrolithotomy ; Renal stone ; Tubeless
Abstract
This study was conducted to report our experience of intraoperative patient selection for tubeless percutaneous nephrolithotomy (PCNL) based on a tentative decision-making algorithm. Thirty-four consecutive patients who were scheduled to undergo tubeless PCNL were included and medical records were obtained from a prospectively maintained database for these patients. After completion of PCNL, the nephrostomy site was observed with a safety guidewire in place. If there was no significant bleeding through the tract, tubeless PCNL was performed, and in cases with significant bleeding or other complications, nephrostomy catheter insertion was performed as usual. In 29 cases (85.3%), tubeless PCNL was performed according to our decision-making protocol. Mean stone size was 7.33 ± 9.35 cm(2). Mean hospital stay was 2.61 ± 1.01 days. The difference between preoperative and postoperative hemoglobin was 0.68 ± 1.22 g/dL (p > 0.05). Visual analog pain scale scores immediately post-operation, on postoperative day one and on the day of discharge were 4.62 ± 1.80, 3.25 ± 1.68 (postoperative day one vs. operative day; p = 0.001), and 1.87 ± 0.83 (the day of discharge vs. operative day; p = 0.001), respectively. The success rate with insignificant remnant stones was 85.2% and complete stone-free rate was 76.5%. In conclusion, tubeless PCNL was performed successfully with low complication rate and reduced pain score through our decision-making algorithm.
Files in This Item:
T201405852.pdf Download
DOI
10.9738/INTSURG-D-13-00120.1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138960
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