World Journal of Laparoscopic Surgery

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VOLUME 10 , ISSUE 1 ( January-April, 2017 ) > List of Articles

RESEARCH ARTICLE

Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College

Muzzafar Zaman, Bhanu P Sharma, Rikki Singal, Karamjot Sandhu, Kamal Sharma, Rahul Yadav, Preeti Grewal

Citation Information : Zaman M, Sharma BP, Singal R, Sandhu K, Sharma K, Yadav R, Grewal P. Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College. World J Lap Surg 2017; 10 (1):1-7.

DOI: 10.5005/jp-journals-10033-1292

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Retroperitoneal pyelolithotomy (RPL) can be used as an alternative to open pyelolithotomy (OP) when other modalities of stone removal fail. This procedure even has potential to replace noninvasive techniques in selective subsets of patients.

Aims and objectives

The aim of this study was to study the efficacy, safety, and outcome of retroperitoneal laparoscopic pyelolithotomy. The study compared the advantages and complications of RPL and OP.

Materials and methods

This study was conducted in the Department of Surgery, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar University, Ambala, from January 2012 to December 2015. A total of 280 patients of solitary renal pelvic stone were selected, out of whom 160 who underwent RPL were considered in group I and 120 patients who underwent OP were considered in group II. The patients included were of age group 12 to 80 years, with unilateral and bilateral solitary renal pelvis calculus and stone size of 10 mm to 3 cm. Patients with recurrent or residual stones after pyelolithotomy, intractable urinary tract infection, and having extrarenal pelvis and any anatomical renal abnormalities were excluded from the study.

Results

In this study, mean age was 37.1 and 46.66 years in groups I and II respectively. Male to female ratio was 2.33:1. Mean operative time was 75.33 ± 16.90 and 65.83 ± 12.35 minutes respectively, in groups I and II respectively (p < 0.001). Pyelotomy closure time and Double-J (DJ) stent insertion time were 5.2 minutes (with standard deviation [SD] of 4.3) and 9.8 (with SD of 3.7) respectively, in group I as compared with 4.2 minutes (with SD of 2.7) and 6.1 (with SD of 2.9) in group II. Mean hospital stay was less in group I at 3.76 ± 0.85 days and, in group II, it was 5.36 ± 1.96 days (p < 0.001). Postoperative anesthesia requirement was 2.23 ± 0.62 days (339 ± 93 mg) and 5.36 ± 0.96 days (804 ± 144 mg) in groups I and II respectively (p < 0.001).

Conclusion

The RPL is a noninvasive and cost-effective method along with minimal scar mark. It has the advantages over OP of having fewer complications, less postoperative pain, better cosmesis, and less hospital stay.

How to cite this article

Sharma BP, Singal R, Zaman M, Sandhu K, Sharma K, Yadav R, Grewal P, Mishra RK. Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College. World J Lap Surg 2017;10(1):1-7.


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