Tubeless percutaneous nephrolithotomy for staghorn stones

Purpose: To assess the outcome and safety of tubeless percutaneous nephrolithotomy (PCNL) to treat patients with staghorn stones. Patients and Methods: Between March 2006 and March 2007, 75 patients underwent 82 PCNLs at our hospital. Of that total, 42 procedures were done without a nephrostomy tube (tubeless group) and 40 procedures were done with insertion of a nephrostomy tube at the end of the procedure (standard group). Results: The mean age was 41.55 +/- 15.15 years and 50.29 +/- 9.42 years in the tubeless group and the standard group, respectively. Seven patients had bilateral stones. None of our patients had organ trauma or any other significant complication. The average operative time was shorter in the tubeless group than in the standard group (93.76 v 109.98 minutes, respectively; P = 0.03). The mean analgesic doses given postoperatively were 79.17 +/- 62.2 and 93.75 +/- 40.7 mg of meperidine in the tubeless group and the standard group, respectively, with no statistically significant difference. The mean postoperative hospital stay was 1.7 +/- 0.6 days in the tubeless group and 4 +/- 1.6 days in the standard group (P < 0.0001). The stone-free rate was 37 units (88.09%) and 35 units (87.5%) units in the tubeless and standard groups, respectively. Conclusions: Complications, operative time, and the length of hospitalization in selected patients undergoing tubeless PCNL were all lower than those seen in the standard group. Tubeless PCNL was thus found to be safe and effective, even in patients with staghorn stones.