Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless
Journal Title: JOURNAL OF UROLOGICAL SURGERY - Year 2018, Vol 5, Issue 2
Abstract
Objective: To determine the scope of tubeless (TL) supracostal percutaneous nephrolithotomy (PCNL) in terms of safety through a randomized controlled trial. Materials and Methods: Adult patients (>14 years) undergoing supracostal PCNL were randomized into two groups (25 patients each), by randomizing odd number for supracostal PCNL with tube (WT) as group A and for TL supracostal PCNL as group B. Both groups received injectable analgesia on operative day and oral analgesia from the first post-operative day. Pain severity was objectively assessed by a visual analogue scale (VAS). Chest X-ray and kidney ultrasonography were done to detect any pleural effusion and perinephric collection. These complications along with thoracostomy and endotracheal intubation were compared between the groups. Results: The mean (VAS) score in group A and B was 7.88±0.83 and 4.12±0.83, respectively (p=0.01). Four of 25 (16%) patients in group A and 1 of 25 (4%) patients in group B developed pleural effusion. Two patients (8%) in group A and 1 patient (4%) in group B required tube thoracostomy (p=0.56). One patient (4%) in group A and 2 patients (8%) in group B developed perinephric collection (p=0.56). A single patient in each group (2%) developed respiratory distress needing elective intubation and ventilation (p=1.00). The mean hospital stay in group B (4.12±0.52 days) was shorter than in group A (4.68±0.85 days) (p=0.01). Conclusion: Tubeless supracostal PCNL is less painful than supracostal PCNL WT, without difference in complication rates. Supracostal PCNL (TL) has a shorter hospital stay.
Authors and Affiliations
Adnan Siddiq, Salman El Khalid, Syed Mamun Mahmud, Sherjeel Saulat, Shariq Anis Khan, Muhammad Hammad Mithani
Keywords
Related Articles
- EP ID EP368796
- DOI 10.4274/jus.1878
- Views 93
- Downloads 0
Penile Abscess Due to Intracavernosal Injection: A Case Report
Penile abscess is a rare clinical entity. We present the case of a 45-year-old paraplegic male who developed penile abscess due to self-administration of intracavernous papaverine injections for erectile dysfunction trea...
Robot-assisted Radical Prostatectomy: How I Do It
In this article, we describe surgical technique for robot assisted radical prostatectomy using the four-arm da Vinci robotic surgical system (SI, Intuitive Surgical, Sunnyvale, CA, USA). We have continually refined our t...
Diode 980 nm Laser Vaporesection of the Prostate: A Comparison of 150 to 250 Watt
Objective: The aim of this study is to compare the efficacy and morbidity of the diode 980 nm laser at two different power settings for vaporesection of the prostate. Materials and Methods: A retrospective evaluation of...
Evaluation of the Prognostic Value of Preoperative Neutrophil-tolymphocyte Ratio in Renal Cell Carcinoma
Objective: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in renal cell carcinoma (RCC). Materials and Methods: Preoperative NLR value in 125 patients who underwent surgical treatment for ren...
Re: Autophagy in Cancer Stem Cells: A Potential Link Between Chemoresistance, Recurrence and Metastasis
.