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Comparative Study
, 31 (6), 1563-8

Nephrostomy in Percutaneous Nephrolithotomy (PCNL): Does Nephrostomy Tube Size Matter? Results From the Global PCNL Study From the Clinical Research Office Endourology Society

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Comparative Study

Nephrostomy in Percutaneous Nephrolithotomy (PCNL): Does Nephrostomy Tube Size Matter? Results From the Global PCNL Study From the Clinical Research Office Endourology Society

Luigi Cormio et al. World J Urol.

Abstract

Purpose: To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL).

Methods: The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at 96 participating centers worldwide. This report focuses on the 3,968 patients who received a NT of known size. Preoperative, surgical procedure and outcome data were analyzed according to NT size, dividing patients into two groups, namely small-bore (SB; nephrostomy size ≤ 18 Fr) and large-bore (LB; nephrostomy size > 18 Fr) NT.

Results: Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P < 0.001), overall complications (15.8 vs. 21.4%; P < 0.001) and a trend toward a lower rate of fever (9.1 vs. 10.7%). Patients receiving a LB NT conversely had a statistically, though not clinically significant, longer postoperative hospital stay (4.4 vs. 4.2 days; P = 0.027). There were no differences in urinary leakage (0.9 vs. 1.3%, P = 0.215) or stone-free rates (79.5 vs. 78.1%, P = 0.281) between the two groups.

Conclusions: LB NTs seem to reduce bleeding and overall complication rate. These findings would suggest that if a NT has to be placed, it should better be a LB one.

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