The efficacy, safety & outcomes of laparoscopic pyelolithotomy (retroperitoneoscopic pyelolithotomy) and its comparison with percutaneous nephrolithotomy
DOI:
https://doi.org/10.7439/ijbar.v6i4.1968Keywords:
Laparoscopy, Retroperitoneoscopy Pyelolithotomy, percutaneous nephrolithotomyAbstract
Objective: The aim of the study was to compare the safety, efficacy and outcomes of laparoscopic pyelolithotomy (RPPL) and its comparison with percutaneous nephrolithotomy (PCNL ) for the management of single large (> 2.0 cm ) renal pelvic calculus.
Methods: This study was performed from May 2009 to March 2012 at S.N. Medical College and Hospital, Agra (INDIA). It included two groups of patients with large renal pelvic stones; only patients with stones 2.0 cm or greater were included. Group1 included 18 patients treated By RPPL and Group 2 included 20 patients treated by the PNL. Differences between the two procedures were compared and analyzed.
Results: There was no difference between the two groups regarding patient demographics and stone size. The mean stone size in RPPL and PCNL groups were 3.7 and 3.90 cm respectively. There was one conversion to open surgery in RPPL group. The mean operative time was significantly longer in Group 2 (RPPL) 145.88 35.54 vs. 76.2 9.21 min p ? 0.005) respectively. The blood loss was 180.2563.28 ml in RPPL as compared to 150.534.06 ml in PCNL group (p-value NS).The mean hospital stay was 4.5 and 3.5 days in RPPL and PCNL group respectively. There is no residual stone in both group and no need of blood transfusion in postoperative period.
Conclusion: Retroperitotoneoscopic pyelolithotomy was associated with longer operating time, more invasive and less cosmetic, require more analgesia, had more blood loss as compared to PCNL.While patients undergo PCNL had shorter hospital stay and rapid returns to normal activity and more cost-effective as compared to RPPL.
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