Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless
Objective: To determine the scope of tubeless (TL) supracostal percutaneous nephrolithotomy (PCNL) in terms of safety through a randomized controlled trial. Materials and Methods: Adult patients (>14 years) undergoing supracostal PCNL were randomized into two groups (25 patients each), by ra...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2018-06-01
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| Series: | Journal of Urological Surgery |
| Subjects: | |
| Online Access: | http://cms.galenos.com.tr/Uploads/Article_18506/JUS-5-73-En.pdf |
| _version_ | 1828030226280480768 |
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| author | Adnan Siddiq Salman El Khalid Syed Mamun Mahmud Sherjeel Saulat Shariq Anis Khan Muhammad Hammad Mithani |
| author_facet | Adnan Siddiq Salman El Khalid Syed Mamun Mahmud Sherjeel Saulat Shariq Anis Khan Muhammad Hammad Mithani |
| author_sort | Adnan Siddiq |
| collection | DOAJ |
| description | Objective:
To determine the scope of tubeless (TL) supracostal percutaneous nephrolithotomy (PCNL) in terms of safety through a randomized controlled trial.
Materials and Methods:
Adult patients (>14 years) undergoing supracostal PCNL were randomized into two groups (25 patients each), by randomizing odd number for supracostal PCNL with tube (WT) as group A and for TL supracostal PCNL as group B. Both groups received injectable analgesia on operative day and oral analgesia from the first post-operative day. Pain severity was objectively assessed by a visual analogue scale (VAS). Chest X-ray and kidney ultrasonography were done to detect any pleural effusion and perinephric collection. These complications along with thoracostomy and endotracheal intubation were compared between the groups.
Results:
The mean (VAS) score in group A and B was 7.88±0.83 and 4.12±0.83, respectively (p=0.01). Four of 25 (16%) patients in group A and 1 of 25 (4%) patients in group B developed pleural effusion. Two patients (8%) in group A and 1 patient (4%) in group B required tube thoracostomy (p=0.56). One patient (4%) in group A and 2 patients (8%) in group B developed perinephric collection (p=0.56). A single patient in each group (2%) developed respiratory distress needing elective intubation and ventilation (p=1.00). The mean hospital stay in group B (4.12±0.52 days) was shorter than in group A (4.68±0.85 days) (p=0.01).
Conclusion:
Tubeless supracostal PCNL is less painful than supracostal PCNL WT, without difference in complication rates. Supracostal PCNL (TL) has a shorter hospital stay. |
| first_indexed | 2024-04-10T14:23:39Z |
| format | Article |
| id | doaj.art-1b3284863d704781ba4c2cf2d126c765 |
| institution | Directory Open Access Journal |
| issn | 2148-9580 |
| language | English |
| last_indexed | 2024-04-10T14:23:39Z |
| publishDate | 2018-06-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Journal of Urological Surgery |
| spelling | doaj.art-1b3284863d704781ba4c2cf2d126c7652023-02-15T16:09:10ZengGalenos YayineviJournal of Urological Surgery2148-95802018-06-0152737710.4274/jus.1878Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless TubelessAdnan Siddiq0Salman El Khalid1Syed Mamun Mahmud2Sherjeel Saulat3Shariq Anis Khan4Muhammad Hammad Mithani5The Kidney Centre Postgraduate Training Institute, Department of Urology, Karachi, PakistanThe Kidney Centre Postgraduate Training Institute, Department of Urology, Karachi, PakistanLifecare Hospital, Clinic of Urology, Abu Dhabi, United Arab EmiratesTabba Kidney Institute, Department of Urology, Karachi, PakistanThe Kidney Centre Postgraduate Training Institute, Department of Urology, Karachi, PakistanThe Kidney Centre Postgraduate Training Institute, Department of Urology, Karachi, PakistanObjective: To determine the scope of tubeless (TL) supracostal percutaneous nephrolithotomy (PCNL) in terms of safety through a randomized controlled trial. Materials and Methods: Adult patients (>14 years) undergoing supracostal PCNL were randomized into two groups (25 patients each), by randomizing odd number for supracostal PCNL with tube (WT) as group A and for TL supracostal PCNL as group B. Both groups received injectable analgesia on operative day and oral analgesia from the first post-operative day. Pain severity was objectively assessed by a visual analogue scale (VAS). Chest X-ray and kidney ultrasonography were done to detect any pleural effusion and perinephric collection. These complications along with thoracostomy and endotracheal intubation were compared between the groups. Results: The mean (VAS) score in group A and B was 7.88±0.83 and 4.12±0.83, respectively (p=0.01). Four of 25 (16%) patients in group A and 1 of 25 (4%) patients in group B developed pleural effusion. Two patients (8%) in group A and 1 patient (4%) in group B required tube thoracostomy (p=0.56). One patient (4%) in group A and 2 patients (8%) in group B developed perinephric collection (p=0.56). A single patient in each group (2%) developed respiratory distress needing elective intubation and ventilation (p=1.00). The mean hospital stay in group B (4.12±0.52 days) was shorter than in group A (4.68±0.85 days) (p=0.01). Conclusion: Tubeless supracostal PCNL is less painful than supracostal PCNL WT, without difference in complication rates. Supracostal PCNL (TL) has a shorter hospital stay.http://cms.galenos.com.tr/Uploads/Article_18506/JUS-5-73-En.pdfPercutaneous nephrolithotomySupracostalPleural effusionThoracostomy |
| spellingShingle | Adnan Siddiq Salman El Khalid Syed Mamun Mahmud Sherjeel Saulat Shariq Anis Khan Muhammad Hammad Mithani Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless Journal of Urological Surgery Percutaneous nephrolithotomy Supracostal Pleural effusion Thoracostomy |
| title | Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless |
| title_full | Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless |
| title_fullStr | Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless |
| title_full_unstemmed | Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless |
| title_short | Supracostal PCNL-Standard Nephrostomy with Day Long Pain Versus Painless Tubeless |
| title_sort | supracostal pcnl standard nephrostomy with day long pain versus painless tubeless |
| topic | Percutaneous nephrolithotomy Supracostal Pleural effusion Thoracostomy |
| url | http://cms.galenos.com.tr/Uploads/Article_18506/JUS-5-73-En.pdf |
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