A modern view on tubeless percutaneous nephrolithotomy

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.4.226895

Keywords:

nephrolithiasis, percutaneous ultrasonic lithotripsy, nephrostomy, tubeless percutaneous nephrolithotomy

Abstract

Urolithiasis ranks second among urological diseases, after inflammatory processes, and first among surgical interventions in urological hospitals. The problem of this disease treatment is a long-term rehabilitation and disablement, which entails a significant increase in costs and requires changes in the tactics of treatment of patients. Since its introduction until today, percutaneous nephrolithotomy (PCNL) is the standard treatment for nephrolithiasis with a stone size of more than 1.5–2.0 cm. In its standard version, PCNL ends with the placement of nephrostomy catheter through the formed parenchymal channel, but there are techniques of the surgery completion either without nephrostomy catheter with a JJ stent – tubeless PCNL, or without nephrostomy and JJ stent at all – totally tubeless PCNL. However, nowadays, the use of tubeless and totally tubeless techniques is one of the most controversial topics in percutaneous nephrolithotomy in terms of safety and efficacy in their application.

Aim. To analyze the results and safety of percutaneous nephrolithotomy by means of tubeless and totally tubeless techniques based on scientific evidence. Analysis of the scientific literature shows that tubeless and totally tubeless PCNL techniques are a safe method of percutaneous surgery and their application reduces pain and analgesic requirements in the postoperative period, shortens the length of postoperative hospital stay, and enhances recovery after surgery in patients, therefore resulting in cost-saving treatment.

Conclusions. Tubeless and totally tubeless PCNLs are recommended for widespread use in urological practice, but it is worth to mention that these techniques should be performed in selected patients and by an operating surgeon with significant experience in percutaneous surgery.

Author Biographies

S. O. Vozianov, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, DSc, Professor, Head of the Department of Urology

A. I. Sahalevych, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, Associate Professor of the Department of Urology

A. I. Boiko, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, Associate Professor of the Department of Urology

F. Z. Haiseniuk, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, DSc, Professor of the Department of Urology

V. V. Kohut, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, Associate Professor of the Department of Urology

B. V. Dzhuran, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, Associate Professor of the Department of Urology

M. D. Sosnin, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, Associate Professor of the Department of Urology

References

Wong, M. Y. (2001). An update on percutaneous nephrolithotomy in the management of urinary calculi. Current Opinion in Urology, 11(4), 367-372. https://doi.org/10.1097/00042307-200107000-00005

Emiliani, E., Talso, M., Baghdadi, M., & Traxer, O. (2017). Renal parenchyma injury after percutaneous nephrolithotomy tract dilatations in pig and cadaveric kidney models. Central European Journal of Urology, 70(1), 69-75. https://doi.org/10.5173/ceju.2017.930

Assimos, D., Krambeck, A., Miller, N. L., Monga, M., Murad, M. H., Nelson, C. P., Pace, K. T., Pais, V. M., Jr., Pearle, M. S., Preminger, G. M., Razvi, H., Shah, O., & Matlaga, B. R. (2016). Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. The Journal of Urology, 196(4), 1161-1169. https://doi.org/10.1016/j.juro.2016.05.091

Türk, C., Neisius, A., Petřík, A., Seitz, C., Skolarikos, A., Somani, B., Thomas, K., Gambaro, G., Davis, N. F., Donaldson, J. F., Lombardo, R., & Tzelves, L. (n.d.). Urolithiasis. European Association of Urology. https://uroweb.org/guideline/urolithiasis/

Osther, P. J., Razvi, H., Liatsikos, E., Averch, T., Crisci, A., Garcia, J. L., Mandal, A., de la Rosette, J., & Croes PCNL Study Group. (2011). Percutaneous Nephrolithotomy Among Patients with Renal Anomalies: Patient Characteristics and Outcomes; a Subgroup Analysis of the Clinical Research Office of the Endourological Society Global Percutaneous Nephrolithotomy Study. Journal of Endourology, 25(10), 1627-1632. https://doi.org/10.1089/end.2011.0146

Desai, M. R., Kukreja, R. A., Patel, S. H., & Bapat, S. D. (2004). Percutaneous Nephrolithotomy for Complex Pediatric Renal Calculus Disease. Journal of Endourology, 18(1), 23-27. https://doi.org/10.1089/089277904322836613

Paul, E. M., Marcovich, R., Lee, B. R., & Smith, A. D. (2003). Choosing the ideal nephrostomy tube. BJU International, 92(7), 672-677. https://doi.org/10.1046/j.1464-410x.2003.04454.x

Fernström, I., & Johansson, B. (1976). Percutaneous Pyelolithotomy. Scandinavian Journal of Urology and Nephrology, 10(3), 257-259. https://doi.org/10.1080/21681805.1976.11882084

Castaneda-Zuniga, W., Formanek, A., Tadavarthy, M., Vlodaver, Z., Edwards, J., Zollikofer, C., & Amplatz, K. (1980). The mechanism of balloon angioplasty. Radiology, 135(3), 565-571. https://doi.org/10.1148/radiology.135.3.7384437

Alken, P. (1985). The telescope dilators. World Journal of Urology, 3(1), 7-10. https://doi.org/10.1007/bf00326880

Grocela, J. A., & Dretler, S. P. (1997). Intracorposeal Lithotripsy. Instrumentation and Development. Urologic Clinics of North America, 24(1), 13-23. https://doi.org/10.1016/s0094-0143(05)70351-7

Wickham, J. E. A., Miller, R. A., Kellett, M. J., & Payne, S. R. (1985). Percutaneous Nephrolithotomy: One Stage or Two? Journal Of Urology, 134(3), Article 634. https://doi.org/10.1016/s0022-5347(17)47339-3

Winfield, H. N., Weyman, P., & Clayman, R. V. (1986). Percutaneous Nephrostolithotomy: Complications of Premature Nephrostomy Tube Removal. Journal of Urology, 136(1, Pt. 1), 77-79. https://doi.org/10.1016/s0022-5347(17)44733-1

Bellman, G. C., Davidoff, R., Candela, J., Gerspach, J., Kurtz, S., & Stout, L. (1997). Tubeless percutaneous renal surgery. The Journal of Urology, 157(5), 1578-1582.

Delnay, K. M., & Wake, R. W. (1998). Safety and efficacy of tubeless percutaneous nephrostolithotomy. World Journal of Urology, 16(6), 375-377. https://doi.org/10.1007/s003450050084

Limb, J., & Bellman, G. C. (2002). Tubeless percutaneous renal surgery: review of first 112 patients. Urology, 59(4), 527-531. https://doi.org/10.1016/s0090-4295(01)01627-2

Gupta, N. P., Kesarwani, P., Goel, R., & Aron, M. (2005). Tubeless Percutaneous Nephrolithotomy. A Comparative Study with Standard Percutaneous Nephrolithotomy. Urologia Internationalis, 74(1), 58-61. https://doi.org/10.1159/000082711

Singh, I., Singh, A., & Mittal, G. (2008). Tubeless Percutaneous Nephrolithotomy: Is it Really Less Morbid? Journal of Endourology, 22(3), 427-434. https://doi.org/10.1089/end.2007.0269

Yew, J., & Bellman, G. (2003). Modified "tubeless" percutaneous nephrolithotomy using a tail-stent. Urology, 62(2), 346-349. https://doi.org/10.1016/s0090-4295(03)00461-8

Shpall, A. I., Parekh, A. R., & Bellman, G. C. (2006). Modification of tubeless percutaneous nephrolithotomy: Anterograde stent with flank tether. Urology, 68(4), 880-882. https://doi.org/10.1016/j.urology.2006.05.037

Choi, M., Brusky, J., Weaver, J., Amantia, M., & Bellman, G. C. (2006). Randomized Trial Comparing Modified Tubeless Percutaneous Nephrolithotomy with Tailed Stent with Percutaneous Nephrostomy with Small-Bore Tube. Journal of Endourology, 20(10), 766-770. https://doi.org/10.1089/end.2006.20.766

Shah, H. N., Mahajan, A. P., Hegde, S. S., & Bansal, M. (2008). Tubeless Percutaneous Nephrolithotomy in Patients with Previous Ipsilateral Open Renal Surgery: A Feasibility Study with Review of Literature. Journal of Endourology, 22(1), 19-24. https://doi.org/10.1089/end.2006.0480

Agrawal, M. S., Agrawal, M., Gupta, A., Bansal, S., Yadav, A., & Goyal, J. (2008). A Randomized Comparison of Tubeless and Standard Percutaneous Nephrolithotomy. Journal of Endourology, 22(3), 439-442. https://doi.org/10.1089/end.2007.0118

Shah, H. N., Sodha, H. S., Khandkar, A. A., Kharodawala, S., Hegde, S. S., & Bansal, M. B. (2008). A Randomized Trial Evaluating Type of Nephrostomy Drainage after Percutaneous Nephrolithotomy: Small Bore v Tubeless. Journal of Endourology, 22(7), 1433-1440. https://doi.org/10.1089/end.2007.0350

Istanbulluoglu, M. O., Ozturk, B., Gonen, M., Cıcek, T., & Ozkardes, H. (2009). Effectiveness of totally tubeless percutaneous nephrolithotomy in selected patients: a prospective randomized study. International Urology and Nephrology, 41(3), 541-545. https://doi.org/10.1007/s11255-008-9517-6

Sagalevich, А. I., Vozianov, S. А., Juran, B. V., Kogut, V. V., Gaysenyuk, F. Z., & Marinichenko, М. V. (2016). Bezdrenazhnaya chreskozhnaya nefrolitotripsiya. Nash pervyi opyt [Drainless transcutaneous nephrolithotripsy. Our first experience]. Klinichna khirurhiia, (9), 43-46. [in Russian].

Sagalevich, A. I., Vozianov, O. S., Ozhohin, V. V., Dzhuran, B. V., Kogut, V. V., Gaysenyuk, F. Z., & Sergiychuk, R. V. (2018). Treatment of ureterolithiasis with the use of percutaneous antegrade ureterolithotripsy. Zaporozhye medical journal, 20(2), 162-166. https://doi.org/10.14739/2310-1210.2018.02.124838

Sahalevych, A., Korets, R., Sergiychuk, R., Ozhohin, V., Khrapchuk, A., & Vozianov, O. (2020). Technique of Totally Tubeless Percutaneous Nephrolithotomy with a Safety Suture Thread. Videourology, 35(2). http://doi.org/10.1089/vid.2020.0080

Xun, Y., Wang, Q., Hu, H., Lu, Y., Zhang, J., Qin, B., Geng, Y., & Wang, S. (2017). Tubeless versus standard percutaneous nephrolithotomy: an update meta-analysis. BMC Urology, 17(1), Article 102. https://doi.org/10.1186/s12894-017-0295-2

Lee, Y. C., Jou, Y. C., Cheng, M. C., Shen, C. H., & Lin, C. T. (2020). Tubeless mini-percutaneous nephrolithotomy for the treatment of renal and upper ureteral stones of ≥3 cm in diameter. Urological Science, 31(2), 68-72. https://doi.org/10.4103/UROS.UROS_82_19

Khadgi, S., El-Nahas, A. R., El-Shazly, M., & Al-Terki, A. (2021). Comparison of standard- and mini-percutaneous nephrolithotomy for staghorn stones. Arab Journal of Urology, 19(2), 147-151. https://doi.org/10.1080/2090598x.2021.1878670

Fareed, R., Shamim, H., & Agarwal, B. K. (2021). Tubeless percutaneous nephrolithotomy (PCNL) as a standard treatment: observations from a tertiary care hospital. International Journal of Surgery Science, 5(1, Pt. E), 277-280. https://doi.org/10.33545/surgery.2021.v5.i1e.623

Aron, M., Goel, R., Kesarwani, P. K., & Gupta, N. P. (2004). Hemostasis in Tubeless PNL: Point of Technique. Urologia Internationalis, 73(3), 244-247. https://doi.org/10.1159/000080835

Jou, Y. C., Cheng, M. C., Sheen, J. H., Lin, C. T., & Chen, P. C. (2004). Cauterization of Access Tract for Nephrostomy Tube-Free Percutaneous Nephrolithotomy. Journal of Endourology, 18(6), 547-549. https://doi.org/10.1089/end.2004.18.547

Mikhail, A. A., Kaptein, J. S., & Bellman, G. C. (2003). Use of fibrin glue in percutaneous nephrolithotomy. Urology, 61(5), 910-914. https://doi.org/10.1016/s0090-4295(03)00112-2

Noller, M. W., Baughman, S. M., Morey, A. F., & Auge, B. K. (2004). Fibrin sealant enables tubeless percutaneous stone surgery. The Journal of Urology, 172(1), 166-169. https://doi.org/10.1097/01.ju.0000129211.71193.28

Shah, H. N., Kausik, V., Hedge, S., Shah, J. N., & Bansal, M. B. (2006). Initial Experience with Hemostatic Fibrin Glue as Adjuvant during Tubeless Percutaneous Nephrolithotomy. Journal of Endourology, 20(3), 194-198. https://doi.org/10.1089/end.2006.20.194

Schilling, D., Winter, B., Merseburger, A. S., Anastasiadis, A. G., Walcher, U., Stenzl, A., & Nagele, U. (2008). Die Verwendung von Gelatine-Thrombin-Matrix zum Verschluss des Arbeitskanals bei der nephrostomielosen minimal-invasiven perkutanen Nephrolitholapaxie. Der Urologe, 47(5), 601-607. https://doi.org/10.1007/s00120-008-1673-x

Aghamir, S. M., Khazaeli, M. H., & Meisami, A. (2006). Use of Surgicel for Sealing Nephrostomy Tract after Totally Tubeless Percutaneous Nephrolithotomy. Journal of Endourology, 20(5), 293-295. https://doi.org/10.1089/end.2006.20.293

Singh, I., Saran, R. N., & Jain, M. (2008). Does Sealing of the Tract with Absorbable Gelatin (Spongostan®) Facilitate Tubeless PCNL? A Prospective Study. Journal of Endourology, 22(11), 2485-2494. https://doi.org/10.1089/end.2008.0321

Erkoc, M. (2020). Tubeless percutaneous nephrolithotomy versus standart nephrolithotomy in geriatric patients: Single surgeon experience. Annals of Medical Research, 27(4), 1168-1171. https://doi.org/10.5455/annalsmedres.2019.12.823

Karami, H., & Gholamrezaie, H. R. (2004). Totally Tubeless Percutaneous Nephrolithotomy in Selected Patients. Journal of Endourology, 18(5), 475-476. https://doi.org/10.1089/0892779041271580

Aghamir, S. M., Hosseini, S. R., & Gooran, S. (2004). Totally Tubeless Percutaneous Nephrolithotomy. Journal of Endourology, 18(7), 647-648. https://doi.org/10.1089/end.2004.18.647

Gupta, V., Sadasukhi, T. C., Sharma, K. K., Yadav, R. G., & Mathur, R. (2005). Tubeless and stentless percutaneous nephrolithotomy. BJU International, 95(6), 905-906. https://doi.org/10.1111/j.1464-410x.2005.05432.x

Crook, T. J., Lockyer, C. R., Keoghane, S. R., & Walmsley, B. H. (2008). Totally Tubeless Percutaneous Nephrolithotomy. Journal of Endourology, 22(2), 267-272. https://doi.org/10.1089/end.2006.0034

Agrawal, M. S., & Agarwal, M. (2013). Percutaneous nephrolithotomy: Large tube, small tube, tubeless, or totally tubeless? Indian Journal of Urology, 29(3), 219-224. https://doi.org/10.4103/0970-1591.117285

Tirtayasa, P., Yuri, P., Birowo, P., & Rasyid, N. (2017). Safety of tubeless or totally tubeless drainage and nephrostomy tube as a drainage following percutaneous nephrolithotomy: A comprehensive review. Asian Journal of Surgery, 40(6), 419-423. https://doi.org/10.1016/j.asjsur.2016.03.003

Lee, J. Y., Jeh, S. U., Kim, M. D., Kang, D. H., Kwon, J. K., Ham, W. S., Choi, Y. D., & Cho, K. S. (2017). Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials. BMC Urology, 17(1), Article 48. https://doi.org/10.1186/s12894-017-0239-x

Chen, Z. J., Yan, Y. J., & Zhou, J. J. (2020). Comparison of tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: A meta-analysis of randomized trials. Asian Journal of Surgery, 43(1), 60-68. https://doi.org/10.1016/j.asjsur.2019.01.016

Farsi, H. M., Mosli, H. A., Al-Zemaity, M. F., Bahnassy, A. A., & Alvarez, M. (1995). Bacteriuria and Colonization of Double-Pigtail Ureteral Stents: Long-Term Experience with 237 Patients. Journal of Endourology, 9(6), 469-472. https://doi.org/10.1089/end.1995.9.469

Ilie, V. G., & Ilie, V. I. (2017). Ureteric Stent Use - Part of the Solution and Part of the Problem. Current Urology, 11(3), 126-130. https://doi.org/10.1159/000447206

Moosanejad, N., Firouzian, A., Hashemi, S. A., Bahari, M., & Fazli, M. (2016). Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial. Brazilian Journal of Medical and Biological Research, 49(4), Article e4878. https://doi.org/10.1590/1414-431x20154878

Candela, J., Davidoff, R., Gerspach, J., & Bellman, G. C. (1997). "Tubeless" percutaneous surgery: a new advance in the technique of percutaneous renal surgery. Techniques in Urology, 3(1), 6-11.

Choi, S. W., Kim, K. S., Kim, J. H., Park, Y. H., Bae, W. J., Hong, S.-H., Lee, J. Y., Kim, S. W., Hwang, T.-K., & Cho, H. J. (2014). Totally Tubeless Versus Standard Percutaneous Nephrolithotomy for Renal Stones: Analysis of Clinical Outcomes and Cost. Journal of Endourology, 28(12), 1487-1494. https://doi.org/10.1089/end.2014.0421

El-Tabey, M. A., Abd-Allah, O. A.-W., Ahmed, A. S., El-Barky, E. M., & Noureldin, Y. A.-S. (2013). Preliminary Study of Percutaneous Nephrolithotomy on an Ambulatory Basis. Current Urology, 7(3), 117-121. https://doi.org/10.1159/000356261

Kroczak, T., Pace, K. T., Andonian, S., & Beiko, D. (2018). Ambulatory percutaneous nephrolithotomy in Canada: A cost-reducing innovation. Canadian Urological Association Journal, 12(12). https://doi.org/10.5489/cuaj.5416

Downloads

Published

2021-07-01

How to Cite

1.
Vozianov SO, Sahalevych AI, Boiko AI, Haiseniuk FZ, Kohut VV, Dzhuran BV, Sosnin MD. A modern view on tubeless percutaneous nephrolithotomy. Zaporozhye medical journal [Internet]. 2021Jul.1 [cited 2024Apr.25];23(4):575-82. Available from: http://zmj.zsmu.edu.ua/article/view/226895

Issue

Vol. 23 No. 4 (2021)

Section

Review

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)