Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from The Global PCNL Study from The Clinical Research Office Endourology Society

作者：Cormio Luigi; Preminger Glenn; Saussine Christian; Buchholz Niels Peter; Zhang Xiaochun; Walfridsson Helena; Gross Andreas J; de la Rosette Jean^*

来源：World Journal of Urology, 2013, 31(6): 1563-1568.

DOI：10.1007/s00345-012-0969-z

• Exit strategy
• Nephrostomy tube size
• Renal access
• Complications
• PCNL

To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). %26lt;br%26gt;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 a parts per thousand currency sign 18 Fr) and large-bore (LB; nephrostomy size %26gt; 18 Fr) NT. %26lt;br%26gt;Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P %26lt; 0.001), overall complications (15.8 vs. 21.4 %; P %26lt; 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. %26lt;br%26gt;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.

• 出版日期2013-12
• 单位北京大学