Laparoscopic pyelolithotomy: its current place in the management of renal pelvis stones

Abstract

Background: Laparoscopic pyelolithotomy is assumed to preserve functional renal parenchyma, and there is a limited risk for immediate or late renal hemorrhage. Therefore, it might be an alternative for the patients in whom maximal preservation of renal parenchyma is necessary. In the present study, we aimed to compare the success rate and perioperative complications of laparoscopic pyelolithotomy. In the present study, we aimed to document and compare the success rate and perioperative complications of laparoscopic pyelolithotomy with published literature about percutaneous nephrolithotomy (PCNL).Methods: We retrospectively reviewed the clinical charts of all patients subjected to laparoscopic pyelolithotomy (18 cases) in the Department of General Surgery at SMIMER Hospital (tertiary care centre), Surat between the period of January 2014 to December 2018. Record of all patients were assessed for demographic profile, co morbidities, routine blood investigations, including RFT, urine cytology and culture sensitivity, specialized investigation as X-ray KUB, USG KUB, IVP/CT-Urography, DTPA scan, all patients were called for follow up evaluation with radiological, clinical and RFT studies at regular intervals upto 3 months.Results: LP is considered a successful alternative therapy for PCNL in selected cases with large renal stones like those in the extra renal pelvis in patients without a history of previous surgery. In addition, laparoscopic pyelolithotomy (LP) can be considered as a reasonable therapeutic option for large staghorn calculus which cannot be removed with a reasonable number of access and sessions of PCNL.Conclusions: Our results show that laparoscopic pyelolithotomy is equally good or better as compared to PCNL in selected cases.