Efficacy and Safety of Tubeless Percutaneous Nephrolithotomy In Selected Thai Patients
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Abstract
Background : Percutaneous nephrolithotomy (PCNL) is the common procedure for removing renal calculi. Routine placement of a nephrostomy tube at the end of procedure was challenged by tubeless technique. There was no previous study of tubeless PCNL in Lampang Hospital.
Objective : To evaluate the efficacy of clinical result and safety of tubeless PCNL.
Material and Method: A descriptive study was conducted on 47 patients with renal calculi who underwent tubeless PCNL in Lampang Hospital between June 2007-August 2008. Nephrostomy tube was not placed after finishing PCNL. Stone burden, distribution and operative time were recorded. Stone free rate, length of stay, postoperative complications, narcotic consumption and blood transfusion were evaluated.
Results: Twenty-eight patients were male and 19 were female. The mean age was 55 years (range, 29-80). Single stone was found in 77.1% and pelvic stone was in 64.6% of cases. The mean size was 25.8 mm-wide (range, 13-40) and 35.2 mm-long (range, 20-67). The stone free rate was 91.7% and 8.3% needed for additional extracorporeal shock wave lithotripsy. The pleural injury was found in 6.2% and sepsis was found in 2.1%. The mean length of stay was 3.4 days (range, 2-13). Pethidine requirement was average 27 mg and no blood transfusion was needed.
Conclusion: Tubeless PCNL in selected patients with renal stone provided satisfactory result. Its efficacy and safety were comparable to other series.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
Shah HN, Kausik VK, Hedge SS, Shah JN, Bansal MB. Tubeless percutaneous phrolithotomy: a prospective feasibility study and review of previous reports. BJU Int 2005; 96: 879-83.
Mantu G, Michael C. Percutaneous Management of the upper urinary tract. In: Louis RK, Andrew CN, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Elsevier; 2007.p.1548-61.
Limb J, Bellman GC. Tubeless percutaneous renal surgery: review of first 112 patients. J Urol 2002; 59:527-31.
Wickham JEA, Miller RA, Kelett MJ, Payne SR. Percutaneous nephrolithotomy: one stage or two?. Br J Urol 1984; 56: 582-4.
Lojanapiwat B, Soonthornphan S, and Wudhikarn S:Tubeless percutaneous nephrolithotomy in selected patients. J Endourol 2001;15:711–3.
Tefekli A, Altunrende F, Tepeler K, Tas A. Tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized comparison. Int Urol Nephrol 2007; 39:57-63.
Shah HN, Kausik VK, Hedge SS, Shah JN, Bansal MB. Safety and efficacy of bilateral simultaneous tubeless percutaneous nephrolithotomy. J Urol 2005; 66:500-4.
Rana AM, Mithani S. Tubeless percutaneous nephrolithotomy: call of the day. J Endourol 2007; 21: 169-72.
Gupta V, Sadasukhi TC, Sharma KK, Yadav RG. Tubeless and stentless percutaneous nephrolithotomy. BJU Int 2005; 95:905-6.
Desai MR, Kukreja RA, Desai MM. A prospective randomized comparision of type of nephrostomy drainage following percutaneous nephrolithotomy: large bore versus small bore versus tubeless. J Urol 2004;172:565-7.