| Comparison of holmium: Yag laser and pneumatic lithoclast in percutaneous nephrolithotomy. | |
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MedLine Citation:
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PMID: 17902519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare holmium Yag laser with lithoclast in patients with renal stones undergoing percutaneous nephrolithotomy (PCNL). METHODS: A comparative cross sectional study was performed on 60 patients undergoing PCNL. Patients with a 2.5 cm stone in renal pelvis, having preoperative negative urine culture, no coagulopathy and fit for general anaesthesia were included, pregnant females were excluded. They were randomly divided into 2 groups of 30 cases each depending on the energy source used. Group A included cases of PCNL subjected to laser treatment and group B had patients undergoing PCNL with pneumatic lithoclast. For each group duration of procedure, any per operative or postoperative complication, residual stone, duration of hospital stay and cost of each procedure were recorded. RESULTS: The average operative time was 125.7 +/- 31.1 minutes in group A and 98.5 +/- 18.7 minutes in group B (P = 0.0001). The overall complication rate was similar in both groups being 13.3% in group A and 23.3% in group B. Residual stone was observed in 17% cases in group A and 13% cases in group B (P = 0.5). The mean postoperative hospital stay was 3.17 +/- 1.6 days in group A and 4 +/- 2.3 days in group B (P = 0.4). Cost analysis showed that the initial capital cost of equipment was 40,000 Euro in laser and 24,000 Euro in pneumatic lithoclast. However because of reuse of fiber the per procedure cost was 60 Euro in laser and 50 Euro in lithoclast group. CONCLUSION: In our experience we found that Holmium: YAG laser and pneumatic lithoclast are both effective and safe lithotriptors for percutaneous stone removal. More operating time was required in laser, more complications encountered with pneumatic lithoclast and a high initial cost of laser. However with increasing experience with laser, more promising results are expected with this new technology. The cost can be compensated by using it in other procedures especially at a public sector hospital. |
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Authors:
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Hammad Afzal Malik; Salman Ahmed Tipu; Nazim Mohayuddin; Gauhar Sultan; Manzoor Hussain; Altaf Hashmi; Syed Ali Anwar Naqvi; Syed Adibul Hasan Rizvi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: JPMA. The Journal of the Pakistan Medical Association Volume: 57 ISSN: 0030-9982 ISO Abbreviation: J Pak Med Assoc Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-10-01 Completed Date: 2007-10-19 Revised Date: 2008-02-12 |
Medline Journal Info:
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Nlm Unique ID: 7501162 Medline TA: J Pak Med Assoc Country: Pakistan |
Other Details:
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Languages: eng Pagination: 385-7 Citation Subset: IM |
Affiliation:
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Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Cost-Benefit Analysis Female Humans Length of Stay Lithotripsy / adverse effects, economics, instrumentation* Lithotripsy, Laser* / adverse effects, economics Male Middle Aged Nephrostomy, Percutaneous / adverse effects, economics, methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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