Endourology & Stone Disease(구연) (E-151) Clinical Efficacy and Safety for Hemostatic sealing agents in Tubeless Percutaneous Nephrolithotomy: A Prospective, Randomized Controlled Trial Urology, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Urology, The Catholic University of Korea, Seoul St. Mary's Hospital YONG SUN Choi, Hyong Woo Moon, Kyu Won Lee, Sae Woong Choi, Woong Jin Bae, U-Syn Ha, Sung Hoo Hong, Ji Youl Lee, Sae Woong Kim, Hyuk Jin Cho Background: The feasibility of tubeless percutaneous nephrolithotomy (PCNL) has been proven. However, postoperative hemorrhage is still a major complication of tubeless PCNL. Many techniques and agents have been developed to reduce this complication, but the benefit or necessity of those is still controversial. / Objectives:  This prospective, randomized controlled trial assessed the efficacy and safety of representative hemostatic agents (Tisseel® and Tachosil®) in tubeless PCNL. / Materials and Methods: Ninety-eight patients undergoing tubeless PCNL were randomized to receive Tisseel®, Tachosil®, or the control at the end of the operation. The three groups were comparable in demographics. At the end of the procedure, the nephrostomy tract was closed deeply with a #1-0 silk stitch in group 1, instilled with 2 to 3 mL of Tisseel® in group 2, and covered with Tachosil®, which was rolled on its longitudinal axis over the yellow (active) surface in group 3. Changes in the hemoglobin level, visual analog scale score, hospital stay, stone-free status, and postoperative computed tomography scan were evaluated to determine the sealant’s efficacy. The modified Clavien classification was used to evaluate the safety of the sealant. Analysis of variance, Mann-Whitney U post-hoc analysis, and Pearson chi-square or Fisher exact test were used to analyze the data. / Results and Conclusion: There were no differences in the changes of the hemoglobin level and blood transfusion requirements among the groups. Serial changes in the hemoglobin level were comparable among the groups during the hospital stay. There were no significant differences in the average visual analog pain scale, stone-free status, and hospital stay. The extent of perirenal hematoma was comparable among the groups. No long-term sequelae were observed in the follow-up period. The efficacy and safety profiles were similar between the experimental groups and control group. Therefore, general use of hemostatic sealing agents in tubeless PCNL should be carefully considered.   keywords : urinary stone, Computed tomography, percutanenous ureterolithotomy