You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2016PD23-06 OUTCOME OF MINI-PCNL VERSUS EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IN TREATMENT OF SINGLE LOWER CALYCEAL STONE 10-20MM WITH FAVORABLE LOWER CALYCEAL ANATOMY: A PROSPECTIVE RANDOMIZED STUDY Mohamed Naguib, Ahmed Eliwa, Mohamed Seleem, Khalid Abdulwahab, Ehab Elsayed, Mahmoud Abdulmaksood, Mohammed Mostafa, Lotfy Bendary, Ahmed Al Ayman, and Hussain Kamel Mohamed NaguibMohamed Naguib More articles by this author , Ahmed EliwaAhmed Eliwa More articles by this author , Mohamed SeleemMohamed Seleem More articles by this author , Khalid AbdulwahabKhalid Abdulwahab More articles by this author , Ehab ElsayedEhab Elsayed More articles by this author , Mahmoud AbdulmaksoodMahmoud Abdulmaksood More articles by this author , Mohammed MostafaMohammed Mostafa More articles by this author , Lotfy BendaryLotfy Bendary More articles by this author , Ahmed Al AymanAhmed Al Ayman More articles by this author , and Hussain KamelHussain Kamel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1745AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study is to compare outcome of Extracorporeal Shock Wave Lithotripsy versus Mini Percutaneous Nephrolithotomy in Treatment of Lower Pole Renal Calculi 10 to 20 mm with favorable lower calyceal anatomy for ESWL namely: Infundibulopelvic angle obtuse > 90°/Short infundibular length < 3cm/Width infundibular > 5mm according to El-Bahnasy et al., 1997 METHODS This is a prospective randomized study carried out from may 2013 till September 2015 and included 40 patients with symptomatic lower pole renal calculi 1 to 2 cm. Patients were randomly allocated in 2 groups: group A [20 patients] treated by mini-PCNL and in group B [20 patients] were treated by ESWL. Inclusion:Single lower pole renal stone -Infundibulopelvic angle obtuse > 90-°Short infundibular length < 3cm-Width infundibular > 5mm (El-Bahnasy et al., 1997)-Stone largest diameter 1-2 cm-.Exclusion criteria coagulopathy, BMI < 40 kg/m2 Stone H.U. > 1000, solitary kidney, Radiolucent stone.Group A Percutaneous Nephrolithotomy (PNCL):Sixteen French Amplatz dilator with its sheath was positioned, allowing the introduction of a 11 F Semirigid ureteroscope. Stones were fragmented using pneumatic lithotripter or Ho-YAG laser and fragments were retrieved by grasper. Group B Extracorporeal Shock Wave Lithotripsy: Electromagnetic Dornier lithotripter device was used. A total of 3000 shocks were delivered at each session or until complete stone disintegration as judged by Fluoroscopy RESULTS he mean stone size was 14±3.1 15 ± 3.3mm [p = 0.44] in group A and B respectively. we didn’t have statistically significance difference between the two groups in the spatial anatomy of lower calyx. The mean operative time in group A was 75.5 min. The mean session time of group B was 45 minutes. The stone free rate was 100% and 75% for group A and B respectively [p= 0.017]. In group A, no patient needed 2nd session or auxiliary maneuvers. In group B, 15 patients were cleared after 1-3 sessions of ESWL[8 cases (40%) had one session, 6 cases (30%) had 2 sessions and one case (5%) had 3 sessions]. ESWL failure occured in 5 cases (25%) [3 cases (15%) with residual stones measuring 5-9 mm after 3rd session of ESWL, 2 cases (10%) give no response after 3rd sessions]. As regard the complications in group A; 3 cases (15%) had fever, 2 cases (10%) had intra-operative bleeding and received 2 units of blood in group B 2 cases (10%) of impaction of fragments in lower ureter with renal colic treated by uretroscopey. CONCLUSIONS Our findings suggest that mini-PCNL is superior to ESWL in the management of lower calyceal stones 1 to 2 cm with favourable calyceal anatomy for ESWL in terms of stone free rate and need of auxilliary procedures; however, ESWL may still be offered as minimal invasive intervention, providing favorable anatomy. © 2016FiguresReferencesRelatedDetailsCited byKallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T, Skolarikos A and Tailly T (2020) Systematic Review and Meta-Analysis Comparing Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery and Shock Wave Lithotripsy for Lower Pole Renal Stones Less Than 2 cm in Maximum DiameterJournal of Urology, VOL. 204, NO. 3, (427-433), Online publication date: 1-Sep-2020. Volume 195Issue 4SApril 2016Page: e507-e508 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mohamed Naguib More articles by this author Ahmed Eliwa More articles by this author Mohamed Seleem More articles by this author Khalid Abdulwahab More articles by this author Ehab Elsayed More articles by this author Mahmoud Abdulmaksood More articles by this author Mohammed Mostafa More articles by this author Lotfy Bendary More articles by this author Ahmed Al Ayman More articles by this author Hussain Kamel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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