Is double-J stent mandatory in complete supine percutaneous nephrolithotomy (csPCNL) for patients with staghorn renal stones?

Abstract

Abstract Background Two different stenting techniques including double-J (DJ) stent and external ureteral catheter (EUC) are commonly used to postoperative drainage in percutaneous nephrolithotomy (PCNL). We aimed to compared the effectiveness of DJ stent and EUC in tubeless complete supine PCNL (csPCNL) for patients with staghorn stones.Methods Between May 2007 and August 2023, a total of 124 patients who underwent tubeless csPCNL for their staghorn stones were enrolled in this analytical cross-sectional study. Patients were divided into two groups: Group 1 (DJ stent; n = 24) and group 2 (EUC; n = 100). Perioperative and postoperative parameters were compared in both groups.Results There were not significant differences in age, sex, body mass index, type of comorbidity disease, stone burden, previous kidney surgery, number of stones, hydronephrosis and anesthesia. The mean operative time of group 1 was significantly longer than group 2 (67.92 ± 28.58 and 55.25 ± 22.81, respectively). (P = 0.05) Although stone free rate in group 1 was higher than group 2 (79.2% vs. 66%); the difference did not consider statistically significant (P = 0.21). The length of hospital stay in group 2 was longer than another group (P = 0.04). The post-csPCNL complications were not significant different between 2 groups (P > 0.05). In group 1, more decreasing changes in serum creatinine after operation was observed. (P = 0.006)Conclusions The insertion of DJ stent has been identified as a safe and effective approach in csPCNL for reducing the duration of hospitalization and serum creatinine for patients with staghorn stones.