Objective: To investigate impacts of different nephrostomy tubes and their fixation ways on patients with nephrolithiasis complicated with renal insufficiency after percutaneous nephrolithotomy.
Methods: A total of 72 renal insufficiency patients were enrolled in this study, who were randomized into three groups with 24 patients in each group according to nephrostomy tube diameter and its fixation way: Group I, i.e. stretch group with 14 Fr silicon tube (Urovision)with balloon; Group II, i.e. not strech group with 14 Fr silicon tube (Urovision) with balloon; Group III, i.e. not strech group with 20Fr latex tube without balloon. The data collected included preoperative serum cretinine, hemoglobin value, midstream urine culture, stone volume, and operative time, and number of operative tract. It was also recorded that the change of hemoglobin between preoperation and 24 h or 72 h postoperation, presence of postoperative extravasation, systemic inflammatory respose syndrome, narcotic usage and blood transfusion.
Results: There were no statistically significant differences among the three groups in terms of the incidence of postooperative extravasation (P=0.301), SIRS(P=0.099) and narcotic usage (P=0.898). In the aspects of the change of hemoglobin between preoperation and 24 h or 72 h postoperation, there were significant differences between group I and group II (P=0.001, P=0.009) or group III (P=0.021, P=0.003). No difference was found between groups II and III (P=0.989, P=0.962). In the aspect of blood transfusion cases, group I (1 case) < group III (6 cases) < group II (10 cases). The number of patients needing blood transfusion in group I was significantly lower than that in group II (P=0.002), but the differences between group III and group I (P=0.102) or group II (P=0.221) were not statistically significant.
Conclusion: It is worth recommending indwelling 14 Fr silicon nephrostomy tube with balloon oppressing the operative tracts, because it could reduce blood loss 24 h and 72 h after operation in patients with nephrolithiasis complicated with renal insufficiency.