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Qi Y, Xing H, Yang S, Peng Z, Chen Y, Qi S. Antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi: a prospective randomized controlled study. Urolithiasis 2024; 52:33. [PMID: 38340170 PMCID: PMC10858820 DOI: 10.1007/s00240-024-01528-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024]
Abstract
The aim is to compare the efficacy and safety between single percutaneous nephrolithotomy (sPNL) and antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) for the treatment of staghorn calculi. A prospective randomized controlled study was conducted at the Second Hospital of Tianjin Medical University. A total of 160 eligible patients were included, with 81 in the sPNL group and 79 in the aPNL group. The study first compared the overall differences between sPNL and aPNL. Then, the patients were divided into two subgroups: Group 1 (with less than 5 stone branches) and Group 2 (with 5 or more stone branches), and the differences between the two subgroups were further analyzed. The results showed that aPNL had a higher stone-free rate (SFR) and required fewer percutaneous tracts, with a shorter operation time compared to sPNL (P < 0.05). Moreover, aPNL significantly reduced the need for staged surgery, particularly in patients with 5 or more stone branches. Moreover, there were no significant differences in the changes of hemoglobin levels and the need for blood transfusions between the sPNL and aPNL groups, and the incidence of multiple tracts was lower in the aPNL group. The two groups showed comparable rates of perioperative complications. We concluded that aPNL resulted in a higher SFR for staghorn calculi, and required fewer multiple percutaneous tracts, reduced the need for staged surgery, and had a shorter operative time than PNL alone, especially for patients with 5 or more stone branches. Furthermore, aPNL did not increase the incidence of surgical complications.
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Affiliation(s)
- Yuanjiong Qi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Haonan Xing
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Shushuai Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Zhongsheng Peng
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Yue Chen
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
| | - Shiyong Qi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
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2
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Levy M, Chin CP, Ravivarapu KT, Al-Alao O, Larenas F, Palese MA. Swiss LithoClast® Trilogy Lithotripter for Use in Robotic Pyelolithotomy. CRSLS : MIS CASE REPORTS FROM SLS 2023; 10:e2023.00027. [PMID: 37671366 PMCID: PMC10476237 DOI: 10.4293/crsls.2023.00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Introduction The Boston Scientific Swiss LithoClast® Trilogy lithotripter was intended for use in percutaneous nephrolithotomy. We performed, to our knowledge, the first two robotic pyelolithotomies using the Trilogy lithotripter for intracorporeal lithotripsy. Case Description Two cases are presented involving a 65-year-old female with a complete left staghorn calculus and hydronephrosis secondary to a left ureteropelvic junction (UPJ) obstruction, and a 69-year-old male with a large left staghorn calculus and multiple large left sided simple renal cysts. In both cases, a robotic pyelolithotomy was scheduled for stone removal along with concurrent UPJ repair and cyst decortication respectively. Following pyeloplasty and cyst decortication respectively, and following stone visualization, the 2.4-mm Trilogy probe was inserted into the 12-mm assistant port and under direct visualization the stone was fragmented and removed using Trilogy's built-in mechanisms. Both patients were treated successfully without complications and were found to be stone-free on follow-up. Conclusion The Trilogy lithotripter may be an effective tool for stone management when introduced during robotic pyelolithotomy and provides additional optionality when manual extraction poses challenges.
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Affiliation(s)
- Micah Levy
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY
| | - Chih Peng Chin
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY
| | | | - Osama Al-Alao
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY
| | - Francisca Larenas
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY
| | - Michael A Palese
- Department of Urology, Icahn School of Medicine at Mt. Sinai, New York, NY
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3
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Ramalingam M, Senthil K, Nachimuthu S. Novel technique (Ramalingam technique) of port site retrograde intra renal surgery through exteriorized ureter during laparoscopy. Asian J Urol 2022. [PMID: 37538163 PMCID: PMC10394279 DOI: 10.1016/j.ajur.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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4
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Rashid AO, Mahmood SN, Amin AK, Bapir R, Buchholz N. Multitract percutaneous nephrolithotomy in the management of staghorn stones. AFRICAN JOURNAL OF UROLOGY 2020. [DOI: 10.1186/s12301-020-00086-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Staghorn stones are difficult to manage with a risk of significant renal impairment and urosepsis. Percutaneous nephrolithotomy is the first-line treatment for staghorn stones. Often, multiple access tracts are needed to render the patient stone-free. PCNL has been combined with SWL, flexible URS (ECIRS), and mini-PCNL to access residual fragments without the need of additional tracts. However, in a country with limited access to technology and a restraint on resources, multitract PCNL still is the preferred option. The aim of this study was to assess the safety and efficacy of multitract PCNL in such an environment.
Methods
We analyzed data on sixty-five patients with staghorn calculus who underwent multitract PCNL for a staghorn calculus. Data included demographics, stone parameters, intraoperative parameters, complications and clinical outcomes. Hb-drop and creatinine changes were assessed pre- and post-OP. Complications were graded according to the modified Clavien-Dindo classification.
Results
In a total of 65 patients [47 males (72%)], 154 percutaneous access tracts were used in 66 renal units. The number of tracts varied between 2 and 4 in a single renal unit. The stone-free rate was 85%. 20% of patients developed grade I, 14% grade II, and 3% grade III b complications. There were no grade IV and V complications.
Conclusion
Multitract PCNL is safe and efficient, with a good stone-free rate and an acceptable complication rate. When auxiliary combination treatments are not available, multitract standard PCNL remains an option.
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5
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Abdessater M, Kanbar A, El Khoury J, El Hachem C, Halabi R, Akl H, Boustany J, El Khoury R. Bilateral Laparoscopic Transperitoneal Pyelolithomy: Dare You Do This? J Endourol Case Rep 2020; 6:99-102. [PMID: 32775690 DOI: 10.1089/cren.2019.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The aim of this article is to describe our technique of bilateral laparoscopic pyelolithotomy (LP) in a 54-year-old patient with bilateral large stones of which one is a staghorn stone (SS). Case Presentation: The patient's legs were extended and spaced from each other; the table was tilted to the right and to the left in a way to use only five trocars for both sides. The calculi were delivered intact at the end of the procedure. Operating time was 208 minutes. Blood loss was 250 mL. Hospital stay was 3 days. Double-J stents were removed 4 weeks later. The patient was stone free with a stable serum creatinine. Conclusion: This case report is the first to describe a bilateral LP for large and SS. This procedure can minimize the postoperative morbidity and is associated with high stone-free rates. It is safe when done by expert surgeons, but further investigations are required to assess its reproducibility.
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Affiliation(s)
- Maher Abdessater
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Anthony Kanbar
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Joey El Khoury
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Charbel El Hachem
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon
| | - Rami Halabi
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Halim Akl
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Johnny Boustany
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Raghid El Khoury
- Department of Urology, Notre Dame des Secours, University Medical Center, Byblos, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
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6
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Shi B, Hong X, Yu J. Management of unilateral staghorn renal stones with concurrent urinary tract infections by retroperitoneal laparoscopic pyelolithotomy with prolonged renal posterior lower segment incision. Exp Ther Med 2019; 18:366-372. [PMID: 31258674 PMCID: PMC6566088 DOI: 10.3892/etm.2019.7545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 04/05/2019] [Indexed: 12/12/2022] Open
Abstract
The present study evaluated the effectiveness and safety of the removal of unilateral staghorn renal stones with concurrent infections by retroperitoneal laparoscopic pyelolithotomy (RLP) with prolonged renal posterior lower segment incision. Patients with staghorn renal stone and concurrent urinary tract infection (UTI) who underwent RLP with prolonged renal posterior lower segment incision as the primary, one-session treatment at our institution between March 2014 and December 2017 were retrospectively reviewed. Routine laboratory tests were performed and the patients received broad-spectrum intravenous antibiotics from at least 3 days prior to the operation. All patients were examined pre-operatively by urinary ultrasonography, computed tomography or intravenous urography. UTI was confirmed by laboratory tests with or without radiographic evidence by an experienced urologist. All patients (18 females and 10 males) successfully underwent the procedures and there was no conversion to open surgery in any case. The mean age was 57.0±10.81 years (age range, 40–74 years) and the mean calculus size was 3.3±0.79 cm. The mean operation time, warm ischemia time and post-operative hospital stay were 114.4±12.09 min, 28.1±4.23 min and 5.8±1.42 days, respectively. The mean hemoglobin drop on day 3 following surgery was 0.5±0.38 g/dl and there was no requirement for blood transfusion in any patient. The mean change of serum creatinine levels between pre-operative baseline and post-operative day 3 or post-operative month 6 was 6.0±20.03 or −4.5±15.13 µmol/l, respectively. The stone-free rate was 100% at 3 days and at 6 months. Mild post-operative complications (Grade I or II) occurred in 6 patients, including temporary and constant elevated body temperature (>38.5°C). No severe complications, including urine leakage, sepsis, residual stones requiring auxiliary procedures, were noted and there were no circumstances requiring further surgical intervention in any of the patients. In conclusion, RLP with prolonged renal posterior lower segment incision is an effective and safe procedure for patients with staghorn renal stones and concurrent UTI, and its feasible application as a single-session monotherapy is particularly convenient considering the financial and medical situation, as well as the patients' preference.
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Affiliation(s)
- Bowen Shi
- Department of Urology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, P.R. China
| | - Xi Hong
- Department of Urology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, P.R. China
| | - Jianjun Yu
- Department of Urology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, P.R. China
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7
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Adam A, Reddy D. "Vaginal Delivery": A Novel Extraction Route for Large Renal Calculi Encountered During Laparoscopic Pyeloplasty. Curr Urol 2019; 12:104-110. [PMID: 31114468 DOI: 10.1159/000489427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/10/2018] [Indexed: 11/19/2022] Open
Abstract
Background To describe a simple, novel stone extraction technique using the transvaginal route for large renal calculi encountered during laparoscopic/robotic pyelolithotomy. Methods After a standard approach laparoscopic pyelolithotomy in a patient with a large (42 × 36 mm) pelvic calculus, Anderson-Hynes pyeloplasty was performed. A transverse posterior colpotomy was performed laparoscopically with the assistance of the Colpassist Vaginal Positioning Device (Boston Scientific) and the calculus was extracted, intact, through the vagina with the aid of an endoscopic retrieval bag. The vaginal incision was then closed intra-corporeally. A systematic review on the topic was also performed. Results The stone was removed in its entirety through an occult vaginal incision. There were no complications reported and the patient was stone free at follow-ups. Conclusions This simple, novel technique is an easily reproducible method, for the removal of large urinary calculi during either traditional laparoscopic or robotic-assisted laparoscopic stone surgery in the appropriate female patient. It avoids the need for additional abdominal incisions or complex techniques involving lithotripsy which may be more complicated and time consuming. All previously published stone extraction techniques for large calculi (greater than 20 mm) within this systematic review are also critically appraised.
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Affiliation(s)
- Ahmed Adam
- Department of Urology, Helen Joseph Hospital, Johannesburg, South Africa.,Department of Paediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, Johannesburg, South Africa.,Wits Donald Gordon Medical Centre, Johannesburg, South Africa.,Division of Urology, Department of Surgery, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Deshin Reddy
- Department of Urology, Helen Joseph Hospital, Johannesburg, South Africa.,Department of Paediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, Johannesburg, South Africa
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8
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Shutov SA, Kovalenko AV, Soboleva OA, Prasolov NV, Danishyan KI. [Surgical treatment of the complication of urolithiasis in patients with inhibitor form of hemophilia]. Khirurgiia (Mosk) 2017:104-107. [PMID: 28374722 DOI: 10.17116/hirurgia20173104-107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- S A Shutov
- Hematology Research Center, Ministry of Health of the Russian Federation, Moscow
| | - A V Kovalenko
- Hematology Research Center, Ministry of Health of the Russian Federation, Moscow
| | - O A Soboleva
- Hematology Research Center, Ministry of Health of the Russian Federation, Moscow
| | - N V Prasolov
- Hematology Research Center, Ministry of Health of the Russian Federation, Moscow
| | - K I Danishyan
- Hematology Research Center, Ministry of Health of the Russian Federation, Moscow
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9
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Alken P. Heart of Darkness. J Endourol Case Rep 2016; 2:180-183. [PMID: 27868094 PMCID: PMC5107655 DOI: 10.1089/cren.2016.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Significant literature has an impact on the reader. Reading the novella Heart of Darkness by Joseph Conrad as a young boy rose emotions comparable to those I felt when losing a patient after percutaneous nephrolithotomy (PCNL) as a grown up. The case of a 37-year-old woman with bilateral staghorn and a fatal outcome after PCNL is presented and alternatives are discussed.
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Affiliation(s)
- Peter Alken
- Department of Urology, Mannheim University Hospital, Mannheim, Germany
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10
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蒲 小, 刘 久, 毕 学, 李 东, 黄 尚, 冯 彦, 林 楚. [Comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy for renal pelvic stones larger than 2.5 cm]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2016; 37:251-255. [PMID: 28219872 PMCID: PMC6779669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To compare the safety, efficacy and complications of laparoscopic pyelolithotomy (LPL) and percutaneous nephrolithotomy (PCNL) for treatment of renal pelvic stones larger than 2.5 cm. METHODS From 2011 to 2016, 32 patients underwent LPL and another 32 patients received PCNL for renal pelvic stones larger than 2.5 cm. The baseline characteristics of the patients, stone size, mean operative time, estimated blood loss, postoperative hospital stay, stone-free rate, postoperative analgesia, blood transfusion, and the intraoperative, early postoperative and long-term complications were compared between the two groups. RESULTS The baseline characteristics and stone size were comparable between the two groups. The mean operative time of LPL and PCNL was 117∓23.12 and 118.16∓25.45 min, respectively (P>0.05). The two groups showed significant differences in the mean estimated blood loss (63∓11.25 vs 122∓27.78 mL, P<0.01) and blood transfusion rate (0 vs 6.2%, P<0.01) but not in postoperative hospital stay (4.5∓1.34 vs 4.8∓2.2 days, P>0.05), stone-free rate (93.1% vs 87.5%, P>0.05) or the postoperative analgesia time (1.7∓0.5 and 1.9∓0.6 days, P>0.05). The incidence of intraoperative complications were significant lower in LPL group than in PCNL group (6.2% vs 25.0%, P<0.01), but the incidences of early postoperative complications (25.0% vs 34.4%, P>0.05) and long-term postoperative complications (9.4% vs 12.5%, P>0.05) were similar between them. CONCLUSION PCNL is the standard treatment for pelvic stones larger than 2.5 cm, but for urologists experienced with laparoscopic technique, LPL provides a feasible and safe option for management of such cases.
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Affiliation(s)
- 小勇 蒲
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 久敏 刘
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 学成 毕
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 东 李
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 尚 黄
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 彦华 冯
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 楚琪 林
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
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11
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蒲 小, 刘 久, 毕 学, 李 东, 黄 尚, 冯 彦, 林 楚. [Comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy for renal pelvic stones larger than 2.5 cm]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2016; 37:251-255. [PMID: 28219872 PMCID: PMC6779669 DOI: 10.3969/j.issn.1673-4254.2017.02.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare the safety, efficacy and complications of laparoscopic pyelolithotomy (LPL) and percutaneous nephrolithotomy (PCNL) for treatment of renal pelvic stones larger than 2.5 cm. METHODS From 2011 to 2016, 32 patients underwent LPL and another 32 patients received PCNL for renal pelvic stones larger than 2.5 cm. The baseline characteristics of the patients, stone size, mean operative time, estimated blood loss, postoperative hospital stay, stone-free rate, postoperative analgesia, blood transfusion, and the intraoperative, early postoperative and long-term complications were compared between the two groups. RESULTS The baseline characteristics and stone size were comparable between the two groups. The mean operative time of LPL and PCNL was 117∓23.12 and 118.16∓25.45 min, respectively (P>0.05). The two groups showed significant differences in the mean estimated blood loss (63∓11.25 vs 122∓27.78 mL, P<0.01) and blood transfusion rate (0 vs 6.2%, P<0.01) but not in postoperative hospital stay (4.5∓1.34 vs 4.8∓2.2 days, P>0.05), stone-free rate (93.1% vs 87.5%, P>0.05) or the postoperative analgesia time (1.7∓0.5 and 1.9∓0.6 days, P>0.05). The incidence of intraoperative complications were significant lower in LPL group than in PCNL group (6.2% vs 25.0%, P<0.01), but the incidences of early postoperative complications (25.0% vs 34.4%, P>0.05) and long-term postoperative complications (9.4% vs 12.5%, P>0.05) were similar between them. CONCLUSION PCNL is the standard treatment for pelvic stones larger than 2.5 cm, but for urologists experienced with laparoscopic technique, LPL provides a feasible and safe option for management of such cases.
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Affiliation(s)
- 小勇 蒲
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 久敏 刘
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 学成 毕
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 东 李
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 尚 黄
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 彦华 冯
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - 楚琪 林
- />广东省人民医院//广东省医学科学院泌尿外科,广东 广州510080Department of Urology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
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