Laparoscopic pyelolithotomy as a monotherapy for the management of intermediate-sized renal pelvic stones.

Abstract

Introduction:Renal calculi are one of the major reason leading to kidney failure or urinal obstructions. Percutaneous nephrolithotomy is considered as the major management option for intermediate to large renal pelvic stones. In the present study we compare Percutaneous nephrolithotomy vs laparoscopic pyelolithotomy procedures in the management of intermediate sized renal pelvic stones.Methods:The time duration of study was between July 2012 and Jan 2014, 20 patients with solitary intermediate sized renal pelvic stones were selected and randomly divided into two groups; group one included 10 patients who were treated by laparoscopic pyelolithotomy and group two included 10 patients who were treated by PCNL. The differences in procedure time, blood loss, stone clearance and duration of hospital stay between the two procedures were compared and analyzed.Results:There was no difference between the two groups regarding patient demographics and stone size. There was statistically significant difference between laparoscopic pyelolithotomy and PCNL regarding mean estimated blood loss (<50 mL vs. 180–250 mL), hospital stay (3–5 days vs. 4–6 days), mean time of postoperative analgesia (2.2 ± 0.9 days vs. 2 ± 0.9 days), and stone-free rate (100% vs. 95%). The operative time was significantly longer in the laparoscopic pyelolithotomy group (80–150 min vs. 45–75 min).Conclusion:Although PCNL is the gold standard for intermediate-sized renal pelvic stones of 2-4 cm, laparoscopic pyelolithotomy is a suitable surgical technique in selected cases.