1. Evaluation of Tube-Less Nephrolithotomy Percutaneous Nephrolithotomy of Patients Suffering from Abnormalities of Kidneys
Muhammad Amjad, Muhammad Khalid, Muhammad Shafique and Muhammad Safdar
ABSTRACT
Objective: The purpose of this study is to evaluate the consequences and secureness of the tube-less Percutaneous Nephrolithotomy in patients suffering from abnormalities of kidneys. Study Design: Prospective study
Place and Duration of Study: This study was conducted at the Department of Urology, Kidney Center, BV Hospital, Bahawalpur from May 2015 to June 2019
Materials and Methods: Total 60 patients suffering from abnormalities of kidney and nephrolithiasis were the part of this research work. These abnormalities contained of horseshoe kidney, rotational abnormalities of the pyelocalyceal structure and ectopic issue of kidneys. We divided the patients into 2 groups randomly; we performed the totally tube-lessmethods in thirty patients (we did not use internal stent and nephrostomy tube in these patients) and 30 patients had experienced standard procedure of percutaneous nephrolithotomy (we performed this procedure with the utilization of both stent and nephrostomy tube). We compared the prevalence of complications, the requirements of transfusions during hospital stay and stone-free frequencies in the patients of both of these groups.
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Results: In the patients group who were undergoing totally tube-less percutaneous nephrolithotomy for the extraction of the stone, the average burden of the stone was 2.54 ± 0.96 cm2. The average stay of the patients in the hospital was 1.3 ± 0.43 days. The mean analgesics need was 4.5 ± 1.6 milligram of morphine. Patients recovered to normal routine activity 10 ± 3.2 days. The complications after the surgery were transfusion of blood in 3.3% (n: 1) patient and high fever in 3.3% (n: 1) patient. The achievement was the rate of free stone as 83.3%. For the standard group of percutaneous nephrolithotomy, the average size of stone was 2.83 ± 0.76 cm2, and average duration of the stay in the hospital was 2.6 ± 0.65 days. The mean analgesics need was 10.4 ± 3.2 milligram of morphine and patients recovered to their normal routine activity in 15.5 ± 3.2 days. There was need of transfusion in only 6.7% (n: 2) patients and 3.3% (n: 1) patient was present with pneumothorax after surgery. Out of thirty patients, 86.7 were free from stones. The disparities among duration of surgery, rates of transfusions, related complications, retreatment andoverall rate of free stone state were not significant in the patients of both groups but there was significant hospitalization stay, analgesics need and duration to recover for normal routine activities. Conclusion: Totally tube-less percutaneous surgery of kidneys is very secure and affectual method for the abnormalities of kidneys and it is very effective even for the patients having medium to large burden of the stones.
Key Words: Surgery, Tube-Less, Morphine, Analgesics, Pneumothorax, Transfusion, Kidneys.
Citation of article: Amjad M, Khalid M, Shafique M, Safdar M. Evaluation of Tube-Less Percutaneous Nephrolithotomy of Patients Suffering from Abnormalities of Kidneys. Med Forum 2020;31(2):2-5.