CHOOSING THE OPTIMAL SIZE FOR THE NEPHROSTOMY TUBE AFTER STANDARD PERCUTANEOUS NEPHROLITHOTOMY: A RANDOMIZED TRIAL
Sh.T.Mukhtarov, F.R. Nasirov, J.X.Mirkhamidov,, Y. U. Safaev
Keywords: Urolithiasis, results of percutaneous nephrolithotomy, size of the nephrostomy tube.
Abstract
Theaimofthestudywasan analysis and evaluation of the standard percutaneous nephrolithotomy results depending on the size of the nephrostomy tube. Urolithiasis is the most frequent and recurrent urological disease. According to the literature, patients with this disease spend almost half (48.3%) of the bed-days of all urological diseases in the hospital.According to international guidelines on urology, percutaneous nephrolithotomy is the main method of surgical treatment for kidney stones larger than 2 cm.It is used for almost any size of stones located in the upper urinary tract, and this technique has proven to be less traumatic, less risky for the patient.
This study includes the results of 300 procedures in patients with complex kidney stones performed in the period from 2020 to 2022.The patients were divided into 3 groups by randomization. Each group included 100 patients whowere installed with a nephrostomy tube (22, 18 and 14 Fr, respectively,) after completion of standard percutaneous nephrolithotomy. In all cases access to the kidney was performed according to the Mannheim technique and surgical tubes 26 Fr were used.
The mean stone size in the groups was 34.1±11.6, 33.4±8.6 and 33.6±10.5, respectively.The surgery time in the groups was 66.7±15.4, 62.3±16.7 and 72.4±21.3 min, respectively. A statistically significant difference was observed between the results of group 2 and 3.The duration of hospital stay of patients in the groups was 3.9±1.2, 3.6±0.9 and 4.7±1.6 days, respectively.