Percutaneous nephrolithotomy: keeping the bridge for one night

Excerpt

We read the retrospective study comparing the outcomes of nephrostomy-free percutaneous nephrolithotomy (PCNL) with early nephrostomy tube removal (after 1 day) with great interest [1]. Only 55 highly selected cases who underwent non-complicated PCNL through a single tract were identified to receive either no nephrostomy tube or an 22-Fr nephrostomy tube. They stated that in the tubeless group, all patients were administered with a ureteral catheter for drainage of the kidney. Preoperatively, the groups were similar. Postoperatively, a large proportion of patients in each group were stone-free. Post-operative events such as hematuria and renal colic were significantly more in tubeless group. Mean dose of post-operative analgesia, mean hemoglobin deficit and hospital days were comparable for both groups. The study has shown that 1-day nephrostomy technique after PCNL is significantly better post-operative course and it is comparable to nephrostomy-free technique in analgesic requirements and hospital stay. The nephrostomy tube also provides a bridge for second look nephroscopy in patients with residual stones. …