TY - JOUR
T1 - Renal drainage after percutaneous nephrolithotomy
AU - Srinivasan, Arun K.
AU - Herati, Amin
AU - Okeke, Zeph
AU - Smith, Arthur D.
PY - 2009/1/10
Y1 - 2009/1/10
N2 - Exit strategy after percutaneous nephrolithotomy (PCNL) is an area of continuing innovation to improve postoperative morbidity and operative outcomes for patients. The two important components of an exit strategy after PCNL are hemostasis and renal drainage. We review the different techniques of renal drainage after PCNL-ie, nephrostomy tube, ureteral stents, and totally tubeless strategy with critical discussion of available evidence for and against each of these techniques. We conclude that the optimal renal drainage method depends on patient characteristics and the operative course; hence, it should be individualized. To simplify this, we group patients undergoing PCNL as routine, problematic, and complicated, based on increasing complexity of the procedure and procedural complications. In routine PCNLs, we favor placement of an ureteral stent or a small-bore nephrostomy tube. In problematic and complicated PCNLs, we think the evidence directs toward placement of a nephrostomy tube, small bore being an option in problematic PCNLs.
AB - Exit strategy after percutaneous nephrolithotomy (PCNL) is an area of continuing innovation to improve postoperative morbidity and operative outcomes for patients. The two important components of an exit strategy after PCNL are hemostasis and renal drainage. We review the different techniques of renal drainage after PCNL-ie, nephrostomy tube, ureteral stents, and totally tubeless strategy with critical discussion of available evidence for and against each of these techniques. We conclude that the optimal renal drainage method depends on patient characteristics and the operative course; hence, it should be individualized. To simplify this, we group patients undergoing PCNL as routine, problematic, and complicated, based on increasing complexity of the procedure and procedural complications. In routine PCNLs, we favor placement of an ureteral stent or a small-bore nephrostomy tube. In problematic and complicated PCNLs, we think the evidence directs toward placement of a nephrostomy tube, small bore being an option in problematic PCNLs.
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U2 - 10.1089/end.2009.1545
DO - 10.1089/end.2009.1545
M3 - Review article
C2 - 19792862
AN - SCOPUS:70350717999
SN - 0892-7790
VL - 23
SP - 1743
EP - 1749
JO - Journal of Endourology
JF - Journal of Endourology
IS - 10
ER -