Selective tubeless minimally invasive percutaneous nephrolithotomy for upper urinary calculi.

BACKGROUND: The aim of this study was to investigate the feasibility and safety of tubeless minimally-invasive percutaneous nephrolithotomy (MPCNL) in a randomized controlled trial.

METHODS: Patients receiving MPCNL from September 2014 to November 2015 were selected according to inclusion and exclusion criteria after nephrolithotomy and divided into study group (tubeless MPCNL) and control group (standard MPCNL) by random number table. A total of 62 patients were included (N.=31 each), and there was no significant difference in age, gender and calculus size between the two groups (P>0.05). All operations were carried out by the same surgeon. The evaluation indexes included postoperative pain, hemoglobin (Hb) drop, incidence of fever, perirenal leakage/hematoma incidence and length of stay, etc. Independent sample t-test was used for comparison of measurement data, and rank-sum test was adopted for comparison of skewed-distributed data. χ2 test was used for comparison of enumeration data.

RESULTS: Significant difference was shown in Visual Analogue Scale (VAS) of pain and average length of stay after surgery between the two groups (P<0.01), but there was no significant difference in postoperative Hb drop, calculus clearance rate and incidence of perirenal seepage/hematoma or fever.

CONCLUSIONS: The strictly chosen tubeless MPCNL is safe and feasible, and can reduce postoperative pain and other discomforts, shorten length of stay and maybe a probable choice for patients.