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Abstract

RÉSUMÉ
Objectif. Décrire la procédure, les résultats et les complications de la néphrolithotomie percutanée(NLPC) tubeless dans le service d’urologie de l’hôpital la RABTA. Patients et méthodes. Il s’est agi d’une étude transversale descriptive avec collecte rétrospective allant du 1er Janvier 2017 au 30 septembre 2018 dans le service d’urologie du Centre Hospitalier Universitaire la RABTA. Résultats. L’étude a porté sur 44 cas de NLPC tubeless. L’âge moyen des patients était de 46,98 ans. Les calculs coralliformes étaient les plus représentés (31,8%). La taille moyenne des calculs était de 3,72 cm et 38,6% des patients avaient des calculs avec une densité comprise entre 500 et 1000UH. La ponction du rein à l’aiguille a été faite sous guidance fluoroscopique et elle a été unique et majoritairement en caliciel inférieur (93,18%). Le traitement du calcul a été essentiellement fait par lithotritie endocorporelle balistique (97,72%). La durée moyenne opératoire a été de 88,6 min avec des extrêmes allant de 40 min à 130 min. La durée moyenne d’hospitalisation a été de 2,91 jours [1 - 8]. Treize patients avaient des complications per et post opératoires, et elles étaient dominées par la fièvre transitoire qui représentait 42,85% des complications. Toutes les complications étaient de Grade 1 et 2 de Clavien Dindo. Le Stone Free Rate (SFR) ou taux sans fragments résiduels était de 65,9%. Conclusion. La néphrolithotomie per cutanée tubeless demeure un traitement efficace des calculs de grande taille et complexe. Elle est sure et engendre moins de complications et un taux de succès de 65,9%. Le futur de la NLPC est orienté vers la mini ou la micro percutanée et la NLPC en ambulatoire.


ABSTRACT
Objective. To describe the procedure, results and complications of tubeless NLPC in the urology department of RABTA hospital. Patients and methods. This was a descriptive cross-sectional study with retrospective collection from January 1st, 2017 to September 30th, 2018 in the urology department of the University Hospital la RABTA. Results. The study included 44 cases of tubeless NLPC. The mean age of the patients was 46.98 years. Coralliform stones were the most common (31.8%). The mean stone size was 3.72 cm and 38.6% of the patients had stones with a density of 500-1000 HU. Needle puncture of the kidney was performed under fluoroscopic guidance and was a single puncture, mostly in the inferior calicium (93.18%). The treatment of the stone was mainly done by ballistic endocorporeal lithotripsy (97.72%). The average operating time was 88.6 min with extremes ranging from 40 min to 130 min. The average hospital stay was 2.91 days [1-8]. Thirteen patients had intra- and postoperative complications, and these were dominated by transient fever, which accounted for 42.85% of complications. All complications were Clavien Dindo Grade 1 and 2. The Stone Free Rate (SFR) was 65.9%. Conclusion. Tubeless percutaneous nephrolithotomy remains an effective treatment for large and complex stones. It is safe and has fewer complications and a success rate of 65.9%. The future of PTNL is oriented towards mini or micro percutaneous and outpatient PTNL.

Keywords

nephrolithotomy rabta tubeless stone free rate néphrolithotomie rabta tubeless stone free rate

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Oumarou, T., B, O., P, S., T, H., H, K., FA, K., B, Z., & Y, N. (2022). Néphrolithotomie Percutanée Tubeless : Expérience du CHU la Rabta de Tunis: Néphrolithotomie per cutanée tubeless : expérience de Tunis. HEALTH SCIENCES AND DISEASE, 23(3). https://doi.org/10.5281/hsd.v23i3.3489
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