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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2022; 14(01): 022-027
DOI: 10.1055/s-0042-1749143
Original Article

Comparative Study of Laparoscopic and Open Pyelolithotomy in the Management of Large Renal Pelvic Stones

Yaqoob Hassan 
1   Department of General and Minimal Access Surgery, Sher - i - Kashmir Institute of Medical Sciences Medical College, Srinagar, India
,
Ajaz Ahmad Rather
1   Department of General and Minimal Access Surgery, Sher - i - Kashmir Institute of Medical Sciences Medical College, Srinagar, India
,
Arshad Bashir
1   Department of General and Minimal Access Surgery, Sher - i - Kashmir Institute of Medical Sciences Medical College, Srinagar, India
,
Ishfaq Ahmad Wani
1   Department of General and Minimal Access Surgery, Sher - i - Kashmir Institute of Medical Sciences Medical College, Srinagar, India
,
Humayoon Rasool
1   Department of General and Minimal Access Surgery, Sher - i - Kashmir Institute of Medical Sciences Medical College, Srinagar, India
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Abstract

Background Large renal pelvic stones can be effectively managed with laparoscopic pyelolithotomy. The aim of this study was to compare the surgical outcomes of laparoscopic pyelolithotomy versus open surgery for the treatment of large renal pelvic stones.

Materials and Methods This prospective comparative study was performed at the Sher-i-Kashmir Institute of Medical Sciences Medical College and Hospital over a period of 8 years. Using computer-generated random numbers, the patients were randomized into two groups: group A received laparoscopic pyelolithotomy, while group B had open pyelolithotomy. The data was collected and analyzed using SPSS software 22.

Results Among 74 patients who met the inclusion criteria, the mean age was 39.18 years with 66.21% being males and a male:female ratio of 1.96. Forty-one (55.41%) patients had open surgery and 33 (44.59%) had laparoscopic pyelolithotomy. The difference in mean operative time of laparoscopy (117.66 minutes) and open (78.13 minutes) surgery was statistically significant (p = 0.05). The mean blood loss was significantly lower in the laparoscopic pyelolithotomy group (62.12 mL) than in the open group (92.07 mL) (p = 0.009). The difference in mean hospital stay between the open and laparoscopic groups was significant (p = 0.02). In both laparoscopy and open surgery, we observed a 100% stone-free rate at the end of 1 month. None of our patients expired during the study period.

Conclusion Laparoscopic pyelolithotomy is a promising alternative to traditional open and other endourological techniques, with encouraging results. Despite its technical difficulty, it yields high stone-free rates and low postoperative morbidity.

Keywords

laparoscopy - open surgery - pyelolithotomy - renal pelvic stones - renal stones

Authors' Contribution

YH, AAR, AB, IAW, and HR were involved in conception and designing, data collection, writing, and critical review. We are taking responsibility for the authenticity and integrity of research process.


Compliance with Ethical Standards

None.




Publication History

Article published online:
22 June 2022

© 2022. The Libyan Authority of Scientific Research and Technology and the Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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