Pasaje de la Cárcova 3526 ARG
(54 11) 4963-7941

“Ambulatory Percutaneous Nephrolithotomy: Our Experience in 156 Cases”

Billordo-Pérez N., Zubieta M.E., Centurión M., Bengoa N., Macias F., Billordo-Pérez C.

Revista Argentina de Urología Vol 84 (1) 2019 (12-18)

In this rich series of patients with ambulatory PCNL, stone free rate in non-staghorn lithiasis was 91%. The methods used by the authors was combining flexible nephoscopy and post-operative ultrasound, which allowed us to trust in the results obtained. Ultrasounds can be confusing when less than 5 millimeter stones are found, but precision when no stones are found it is nearly 95%. There is evidence about the safety of a tubeless approach (without nephrostomy tube NT). Based on their own results, the authors avoided a NT in almost 80% of patients. Tubeless procedures (without JJ) were used in 20% of the patients and will surely become the standard procedure in non -complicated cases. Stent syndrome produces a strong impairment in quality of life. Combining mini perc (less bleeding) with flexible nephoscopy (higher stone free rate) allows us to perform more tubeless procedures and in selected cases, a totally tubeless approach.

Dr. Pablo Contreras
Jefe de la sección de Endourologìa y Litiasis del Hospital Alemàn
Buenos Aires, Argentina

References:

Ganesan V, De S, Greene D, Torricelli FC and col. Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions? BJU Int. 2017 Mar;119(3):464-469. doi: 10.1111/bju.13605. Epub 2016 Aug 17.

Zhong-JunChen, You-JiYan, Jia-JieZhou. Comparison of tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: A meta-analysis of randomized trials. Asian Journal of Surgery Volume 43, Issue 1 2020, Pages 60-68

Joel E. Abbott, Samuel G. Deem, Natalie Mosley, and col. Are we fearful of tubeless percutaneous nephrolithotomy? Assessing the need for tube drainage following percutaneous nephrolithotomy Urol Ann. 2016 Jan-Mar; 8(1): 70–75