Comparative analysis of standard, tubeless and total tubeless percutaneous nephrolithotomy: A prospective study

Abstract

Introduction: This study was done to review and compare safety, effectiveness and advantages of total tubeless percutaneous nephrolithotomy (PCNL), tubeless PCNL with standard PCNL. Methodology: This prospective comparative study involving 30 patients in each total tubeless PCNL, tubeless PCNL and standard PCNL group from Feb 2021 to June 2022. Result: Significant difference was found in mean duration of surgery ( p < 0.01), mean hospital stay ( p < 0.01), mean VAS post op score ( p < 0.01), mean time to return to normal activity ( p < 0.01) in total and tubeless PCNL group as compared with standard PCNL. While no significant difference found in mean haemoglobin drop ( p = 0.1417), blood transfusion ( p = 3721), incidence of urine leak ( p = 0.13), need of accessory secondary procedure ( p = 0.1322) and associated complications ( p = 0.5939) among three groups. Conclusion: Study observed that total tubeless, tubeless PCNL is a safe and efficient technique. It is significantly associated with the advantages of shorter hospital stay, shorter time to return to normal activity, lower postoperative pain scores. Total tubeless PCNL obviates need of second procedure of removing DJ stent. Standard, tubeless and total tubeless PCNL have similar post op complication rate. Study thus concludes that total tubeless, tubeless PCNL can be used as a substitute for traditional standard PCNL.