Comparsion between Tubeless and Standard Nephrolithotomy of Renal Resistive Index in Kidneys of Patients

Objective: We aimed to compare renal injury and vasculary resistance between standard and tubeless percutaneous nephrolithotomy (PCNL), in patients who were operated for kidney stone, by using colored Doppler ultrasonography (CDU). Methods: All consecutive PCNLs were evaluated between 2009 and 2011. The patients with access to the kidney provided in the lower pole and who visited our outpatient clinic regularly were enrolled in the study. Patients were divided into 2 groups; patients who had standard PCNL were included in Group 1 (n=22) and patients who had tubeless PCNL were included in Group 2 (n=21). The demographic data were collected from files of patients and were recorded. CDU was performed in all patients for evaluating resistive index (RI), parenchymal thickness and parenchymal echogenity before operation, after operation early postoperative (after 7 days nephrostomy catheter was taken off in Group 1, 7 days from operation in Group 2) and midterm postoperative period (6 months after operation). Statistical significant p was accepted as p<0.05. Results: Mean age was 47.18 +/- 1.3 years. There were 8 female and 14 male patients in Group 1 (n=22), 4 female and 17 male patients in Group 2 (n=21). The mean follow-up was 10.71 +/- 1.2 months. There was no statistical difference for mean age, body mass index, stone burden, serum creatine, hemoglobin, delta hemoglobin, complications, urinary culture, stone free rate between groups. Hospital stay was longer in Group 1 than Group 2 (p=0.04). Mean operation time was shorter in Group 2 than Group 1 (p=0.002). In the comparison of before and early postoperative operation, there were differences in groups for CDU, including RI, parenchymal thickness. There was an increase for RI and decrease for parenchymal thickness in midterm follow-up period when comparing RI before operation in the lower pole of the operated kidney. There was no difference in renal echogenity in CDU in groups between before and mid-term follow-up period. Conclusion: Recently, PCNL has been employed as a minimally invasive and safe procedure for kidney stones bigger than 2 cm. Tubeless PCNL was successful as standard PCNL, provided shorter hospital stay than standard PCNL and caused less damage to the kidney in the early follow-up period.