Order of Removing Nephrostomy Tube and Catheter after Percutaneous Nephrolithotomy

Gao Zhengyan; Zheng Xinmin; Liu Tongzu

Abstract：Objective To compare postoperative complications caused by order of removing nephrostomy tube and catheter after percutaneous nephrolithotomy. Methods Patients with bilateral or unilateral staghorn calculi who underwent F22 standard percutaneous nephrolithotomy( PCNL),standard fourth generation Swiss Lithoclast Master (EMS)in our hospital from Jan. 2013 to Feb. 2014 were analyzed retrospectively. 25 patients who were intolerant to the urethral catheter were enrolled to the observation group. Catheter was removed 1 ~ 3 days after operation and ne-phrostomy tube was removed after a evaluation by KUB or renal CT. 45 patients in the same period served as the con-trol group. Nephrostomy tube was removed 3 ~ 5 days after operation and catheter was removed 1 ~ 2 days later. Double J tube was kept for 4 ~ 6 weeks and all patients were followed up for 2 months. Results In the observation group,the averaged length of stay was(8. 88 ± 1. 09)days,fever after extubation was observed in 8 cases(33. 33% ),urinary ex-travasation was observed in 4 cases(15. 56% ),repeated catheterization occurred in 8 cases(33. 33% ),perinephric puncture drainage was observed in 3 cases(8. 89% ). Hospital stay,incidence of fever after extubation,urinary extrav-asation,repeated catheterization,perinephric puncture drainage were significantly increased in observation group(P ﹤0. 05). However,the incidence of delayed bleeding was not affected(P ﹥ 0. 05). There was no significant difference in renal dysfunction after 2 months follow - up between the two groups(P ﹥ 0. 05). Conclusion It is safe and feasible to remove nephrostomy tube first after percutaneous nephrolithotomy.