Comparative Study On Whether Pyelostomy Is Necessary For Percutaneous Nephrolithotomy

Objective: To compare the difference on incidence of operative complication and index of infections related to inflammation between placing pyelostomy tube or not in percutaneous nephrolithotomy(PCNL), and evaluate the necessity of putting pyelostomy tube in percutaneous nephrolithotomy(PCNL).Methods: From October 2013 to April 2015, 60 patients diagnosed as renal calculi and ureteral calculi who needed PCNL treatment were randomly divided into 2 groups, each group had 30 patients. Group A : Patients treated with PCNL without pyelostomy(Tubeless PCNL group), Group B : Patients treated with PCNL with pyelostomy(Tubular PCNL group), the other operating procedure was identical. The serum concentration of TNF-α,IL-6 and CRP at three time points: immediately after operation,24 hours after operation and 72 hours after operation, were tested. The postoperative complications were evaluated by a modified Clavien classification. And some other references such as the operation time, hospital stay after the operation, hospitalization costs and residual stone rate were also recorded.Result: 60 cases were all adopted by a single F22 channel to do the PCNL. all PCNL were completed smoothly as expected without conversed to open surgery or suspend operation due to massive hemorrhage. There are no significant differences(P>O.05) on operation time, changes of postoperative hemoglobin, percentage of calculi residual and incidence of classⅡ~Ⅴ postoperative complications between Group A and B. But other indexes, such as hospital stay time, drug acetanilide cases, hospitalization costs and incidence of Ⅰclass postoperative complications, there were lower in Group A than that in B group(P<0.05). the serum concentration of TNF-α、IL-6 and CRP in each group were both increased 48 hours after the operation and then both decreased 72 hours later. There were no statistical difference at each group at the three measured time points(P>O.05)).Conclusion: Compared with tubular PCNL, tubeless PCNL has its comparative advantages in some aspects. it is not necessary to do pyelostomy as routine when doing percutaneous nephrolithotomy(PCNL).