Outcome of Tubeless Percutaneous Nephrolithotomy in Patients with Single Kidney; A Cross-Sectional Study

Majid Salasi; Robab Maghsoudi; Masoud Etemadian; Mohammad Yaghoobi; Farzam Mahmoodi; Kaveh Mehravaran; Nasrollah Abian

doi:10.18502/jimc.v6i4.13448

Majid Salasi Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Robab Maghsoudi Department of Urology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Masoud Etemadian Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Mohammad Yaghoobi Takhte Jamshid Hospital, Alborz University of Medical Sciences (ABZUMS), Karaj, Iran
Farzam Mahmoodi Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Kaveh Mehravaran Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Nasrollah Abian Department of Urology, 5 Azar Hospital, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran

DOI: https://doi.org/10.18502/jimc.v6i4.13448

Keywords: Percutaneous nephrolithotomy, Renal stones, Tubeless PCNL, Single kidney

Abstract

Background: While tubeless Percutaneous Nephrolithotomy (PCNL) is becoming more popular, there might still be doubt in performing it on single kidney patients. This study is performed to assess outcomes and complications of tubeless PCNL in patients with single kidney.

Methods: In this cross-sectional study, 134 single kidney patients who underwent tubeless PCNL for renal stones, were assessed for outcomes including stone-free rate, duration of operation, length of hospital stay, changes in serum creatinine and hemoglobin levels, bleeding, infectious complications, damage to adjacent organs, and mortality. These outcomes were compared based on age, sex, history of comorbidities, history of interventions for kidney stones and the number of accesses during the operation.

Results: Mean duration of operation was 139.14 minutes. Mean length of hospital stay was 2.59 days. In total, 11.9% of patients required intraoperative blood transfusion and 3.7% required ICU admission due to complications. The most common postoperative complications included fever, hematuria and UTI. Initial stone-free rate after surgery was 67.2% and two weeks later 76.9%. No mortality was reported. Postoperative serum creatinine levels increased slightly in short term, however, improved significantly in long-term. Comorbidities such as diabetes mellitus, hypertension, ischemic heart disease, and chronic kidney disease were associated with a higher incidence of minor and major complications of tubeless PCNL and a lower rate of stone-free rate.

Conclusion: Tubeless PCNL is a relatively safe, feasible and efficient method with acceptable complications in single kidney patients.