Document Detail


Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy?
MedLine Citation:
PMID:  16327299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Large pelvic stones are frequently managed with percutaneous nephrolithotomy (PCNL) but laparoscopic transperitoneal pyelolithotomy (LTP) can be an alternative. We compared PCNL and LTP for the treatment of pelvic stones >20 mm in diameter. PATIENTS AND METHODS: Between November 1999 and November 2004, 16 consecutive patients, mean age 42, with a single pelvic stone >20 x 10 mm (group I), underwent LTP as first-line treatment or after shockwave lithotripsy failure. They were compared with a similar population of 16 consecutive patients, mean age 45 (group II), who underwent PCNL for the same indication and were assessed retrospectively. We evaluated operative characteristics, complications, and results for each technique. RESULTS: There was no difference between the two groups regarding the characteristics of patients and stones. Operative time duration was significantly longer in group I (129 vs. 75 min; p = 0.001) and conversion was required in 2 patients (12%). The main postoperative complications were urinary leakage (2 patients, 12%) in group I and bleeding (3 patients, 18%) in group II, but only 1 required blood transfusion. Mean hospital stay was respectively 6.5 and 5.6 days in groups I and II (p = 0.17). Stone-free rates were assessed at 3 months and were not different between group I and group II (88 vs. 82%). CONCLUSIONS: The operative time of LTP is longer and the results of both techniques are comparable but postoperative morbidity is different. Specific indications of each technique must be determined although PCNL remains the gold standard for most large pelvic stones.
Authors:
Paul Meria; St?phane Milcent; Fran?ois Desgrandchamps; Pierre Mongiat-Artus; Jean Marc Duclos; Pierre Teillac
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Urologia internationalis     Volume:  75     ISSN:  0042-1138     ISO Abbreviation:  Urol. Int.     Publication Date:  2005  
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-02-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417373     Medline TA:  Urol Int     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  322-6     Citation Subset:  IM    
Affiliation:
Department of Urology, St-Louis Hospital, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Decision Making*
Follow-Up Studies
Humans
Kidney Calculi / radiography,  surgery*
Laparoscopy / methods*
Length of Stay
Middle Aged
Nephrostomy, Percutaneous / methods*
Peritoneal Cavity / surgery
Retrospective Studies
Severity of Illness Index
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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