Comparison of outcomes in totally tubeless percutaneous nephrolithotomy according to nephrostomy tract sealing with fibrin versus gelatin matrix: a propensity score matching study.

摘要: To investigate and compare surgical outcomes in totally tubeless percutaneous nephrolithotomy (ttPCNL) patients according to the type of sealant during nephrostomy tract closure, records 158 who underwent ttPCNL were retrospectively reviewed. Fibrin [Tisseel®; n = 107, fibrin-only (FS)] or gelatin matrix hemostatic [FloSeal®; n = 51, (GS)] was applied closure surgeon’s preference. On first postoperative day, computed tomography (CT) scanned for all patients. Unsatisfactory radiological outcome (URO) defined as any hematoma urinoma (≥ 2 cm) on CT. clinical (UCO) adverse event requiring additional intervention. Both UROs UCOs sub-classified either hemorrhage drainage related. 2:1 propensity score matching parameters. Median age 58 (19–78) years a mean stone size 2.1 ± 1.1 cm. The treatment success rate (stone free < 4 mm residual) among 91.1% (144/158). occurred 35.4% (86/158) 11.4% (18/158) cases, respectively. Neither frequency URO nor hemorrhage-related UCO different type. However, drainage-related more prevalent GS group, mainly due higher ureter stenting rate. pain severity length hospitalization comparable between groups. In summary, using rather than FS did not worsen outcomes. risk occlusion temporary ureteral increased.