The feasibility of multiple-tract mini-percutaneous nephrolithotomy as an overnight surgery for the treatment of complex
- PDF / 620,076 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 144 Views
ORIGINAL PAPER
The feasibility of multiple‑tract mini‑percutaneous nephrolithotomy as an overnight surgery for the treatment of complex kidney stones Zhijian Zhao1 · Shanfeng Yin1 · Huacai Zhu1 · Donglong Cheng1 · Yongda Liu1 · Guohua Zeng1 Received: 6 April 2020 / Accepted: 4 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract To demonstrate the feasibility of applying multiple-tract percutaneous nephrolithotomy (PCNL) as an overnight surgery for treatment of complex kidney stones. We reviewed a prospectively collected database of all multiple-tract PCNL planned as overnight surgery performed by a single surgeon since 2018. A clinical pathway including the removal of nephrostomy tube and discharge on the morning after surgery was carried out. A definition for tube removal was outlined. Ability to adhere to the pathway and achieving the described parameters and whether any resulting complications occurred were determined. A total of 136 consecutive patients were enrolled with mean stone burden of 960.5 mm2 and 5.1 cm. Mean operative time was 71.7 ± 30.7 min. The average hemoglobin drop was 17.6 ± 12.2 g/L, and the incidence of drop > 25 g/L was 21.9%. Overall, 125 patients (91.9%) but 11 patients were discharge on postoperative day 1. One case required readmission. Among the 11 patients, 7 patients (5.1%) underwent a delayed tube removal (≥ 2 days) and 4 patients underwent complications after next-day nephrostomy tube removal, including renal colic (2 cases), hydrothorax (1 case), and fever (1 case). Postoperative fever or severe hematuria was the major reason for delayed nephrostomy tube removal. The total complication rate was 8.8% (n = 12). Multiple-tract PCNL as an overnight surgery can be safely performed by experienced surgeons in most patients. An early nephrostomy tube removal could be achieved in nearly 95% patients. Keywords Percutaneous nephrolithotomy · Nephrostomy tube · Complications · Early discharge · Overnight surgery
Introduction Percutaneous nephrolithotomy (PCNL) is still irreplaceable as the most effective endoscopic modality in the treatment of complex kidney stones [1]. Its tubeless technique without need of drainage via nephrostomy tube has been implemented in selected patients [2–4]. However, surgeons usually required many wisdoms and encourage for performing the tubeless of multiple-tract PCNL; therefore, indwelling Zhijian Zhao and Shanfeng Yin contributed equally to this work as the co-first authors. * Yongda Liu [email protected] * Guohua Zeng [email protected] 1
Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1#, Haizhu District, Guangzhou 510230, Guangdong, China
nephrostomy tube is considered to be safer and more commonly used over round the world [5]. Generally, urinary drainage and tract tamponade are the two key roles of placement of nephrostomy tube after PCNL with multiple tracts establ
Data Loading...
