Zhang Yuanpeng, Li Xinwei, Yang Gen, Liu Lei, Zhang Xiaoping, Li Wencheng
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Urology, The First People's Hospital of Xiaochang County, Xiaogan, 432900, Hubei, China.
Sci Rep. 2025 Jan 7;15(1):1106. doi: 10.1038/s41598-024-84806-1.
The tubeless percutaneous nephrolithotomy (PCNL) is highly favored by endourological urologists for its advantages in patient experience and length of hospital stay. However, there is currently no guideline or consensus that precisely describes tubeless PCNL. This study explores tubeless PCNL from two aspects: patient selection and technical improvements. Clinical data of 40 cases of conventional PCNL and tubeless PCNL patients operated by the same surgeon between December 2023 and April 2024 were analyzed. The changes in the preoperative and postoperative renal function, hemoglobin and inflammatory markers were evaluated, and the operative time, pain scores, and length of hospital stay were also included. Both groups of patients achieved complete stone clearance (100%). Compared to the conventional PCNL group, the tubeless PCNL group had lower pain scores (P < 0.001) and shorter hospital stays (P = 0.005). There were no statistically significant differences between the two groups in terms of operative time (P = 0.83), renal functional impact (P = 0.699), hemoglobin reduction (P = 0.93), and changes in inflammatory markers (P > 0.05). Tubeless PCNL demonstrated better patient experience and shorter hospital stays. Tubeless PCNL patients were strictly selected according to our criteria and operated based on traditional experience and the improved technical standards in this study. Tubeless PCNL is safe and feasible under these conditions. Retrospectively registered: 0620, August, 2024.
无管经皮肾镜取石术（PCNL）因其在患者体验和住院时间方面的优势而备受泌尿外科内镜医生青睐。然而，目前尚无精确描述无管PCNL的指南或共识。本研究从患者选择和技术改进两个方面探讨无管PCNL。分析了2023年12月至2024年4月间由同一位外科医生实施的40例传统PCNL患者和无管PCNL患者的临床资料。评估术前和术后肾功能、血红蛋白及炎症标志物的变化，并纳入手术时间、疼痛评分和住院时间。两组患者均实现结石完全清除（100%）。与传统PCNL组相比，无管PCNL组疼痛评分更低（P < 0.001），住院时间更短（P = 0.005）。两组在手术时间（P = 0.83）、对肾功能的影响（P = 0.699）、血红蛋白降低情况（P = 0.93）及炎症标志物变化方面无统计学显著差异（P > 0.05）。无管PCNL显示出更好的患者体验和更短的住院时间。无管PCNL患者严格按照我们的标准进行选择，并根据传统经验和本研究改进的技术标准进行手术。在这些条件下，无管PCNL是安全可行的。回顾性注册：0620，2024年8月。
