OUTCOME OF TUBELESS PERCUTANEOUS NEPHROLITHOTOMY IN THE TREATMENT OF SINGLE RENAL STONES

Objectives: To, evaluate the outcome of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of renal stones.
Patients And Methods: This descriptive study was conducted in the institute of kidney diseases Hayat Abad medical
complex Peshawar from June 2012 to February 2013 on 33 patients. A 6 French(Fr) ureteral catheter was inserted into the
target ureter in supine position. In prone position the desired calyx was punctured with 18 gauge needle. The tract was
dilated by alken dilators followed by insertion of Amplatz sheet. Using a 24 Fr rigid nephroscope, the stone was readily
identified and crushed with the use of a pneumatic lithoclast and the fragmented stones were removed with a forcep.
Results: A total of 33 patients, 19 male and 14 female were included in the study. Mean age was 27.6 years (range
14 to 59). Most of the patients 19(57.57%) had right kidney stones. Approach below 12th rib was made in 23(69.69%)
and above it in 10(30.31%) patients. The overall stone free rate was 30 (90.90%). One patient (3.03%) had an 11 mm
residual stone, which was cleared in 8 weeks through extracorporeal shockwave lithotripsy (ESWL). One patient (3.03%)
had clinically insignificant residual stones which cleared spontaneously in 4 weeks time. The mean operative time was
65.7 minutes (38-108).
Conclusion: Tubeless PCNL is associated with less pain, less debilitation, lower costs and a shorter hospital stay