a randomized comparison of totally tubeless and standard percutaneous nephrolithotomy in elderly patients：一个在老年患者完全无内胎和标准经皮肾镜取石术的随机对照研究.pdfVIP

Endourology and Stones A Randomized Comparison of Totally Tubeless and Standard Percutaneous Nephrolithotomy in Elderly Patients Cengiz Kara, Berkan Resorlu, Mirze Bayindir, and Ali Unsal OBJECTIVES To evaluate the safety, effectiveness, and feasibility of totally (tubeless and stentless) tubeless percutaneous nephrolithotomy (PCNL) in elderly patients. Tubeless PCNL is performed widely in adult patients. METHODS A total of 60 patients with renal stones were enrolled in this study. Patients were randomized to either a totally tubeless approach (group 1, 30 patients) or placement of an 18F nephrostomy tube (group 2, 30 patients). Patients were considered uncomplicated and suitable for random- ization at the end of the operation if there was no significant bleeding or residual stone, and the pelvicaliceal system was intact. The incidence of complications, hospital stay, analgesic require- ments, and stone-free rates were compared in 2 groups. RESULTS The mean age of the patients at receipt of the surgical procedure was 67.7 years (range, 60-77) vs 66.5 years (range, 61-74), respectively. The mean stone size was 25.6 vs 22.3 mm and stone-free rate was 86% vs 83% for group 1 and 2, respectively (P .05). The mean hospitalization time was 1.5 and 3.2 days (P .001), the mean analgesia requirement (pethidine HCl) was 0.5 and 1.4 mg/kg, respectively (P .01). Decrease in hematocrit was similar in 2 groups. No blood transfusions were needed. CONCLUSIONS Totally tubeless PCNL