Tubeless percutaneous renal surgery: Review of first 112 patients

Objectives. To assess the outcome and safety of the first 112 patients undergoing tubeless percutaneous renal surgery. Methods. A total of 116 renal units in 112 patients underwent tubeless percutaneous renal surgery from December 1995 to November 2000 performed by a single urologist. The "tubeless" procedures consisted of nephrolithotripsy or endopyelotomy. An antegracle internal ureteral stent was placed during surgery, as was a Foley catheter for bladder drainage, in all patients. Nephrostomy tubes were not used in any patient. The incidence of complications, length of hospitalization, outcomes, transfusion requirements, stone burden, and stone-free rates were obtained by chart review. Results. Of the 1 12 patients, 86 patients underwent percutaneous stone extraction and 26 patients underwent percutaneous antegracle endopyelotomy. In the group of patients undergoing percutaneous stone extraction, the mean stone burden was 3.3 0 cm(2). Patients stayed in the hospital an average of 1.25 days. A total of 5 patients required postoperative transfusions. One patient was found on readmission to have a pseudoaneurysm. A 93.0% stone-free rate was achieved. The correlations between transfusion rates, days of hospitalization, and outcome with stone burden were not statistically significant (P = 0.56, 0.78, and 0.18, respectively). For the endopyelotomy group, the mean length of hospitalization was 1.56 days. Only I patient required a transfusion, and 3 patients had postoperative complications. Of the 26 patients, 88.5% had a successful outcome from their endopyelotomy. Conclusions. Tubeless percutaneous renal surgery is a safe and effective procedure and can be performed in patients even with a moderate stone burden.