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Percutaneous Nephrolithotomy Versus Laparoscopy in the Management of Large Proximal Ureteral Stones: The Experience of Two Different Settings

Seyed Habibollah Mousavi Bahar, Shahriar Amirhassani, Akbar Nouralizadeh, Nikan ZerafatJou, Jaber Rasiuli
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Abstract

Purpose: This study was conducted to compare the success rate and complications of percutaneous nephrolithoto­my (PCNL) and laparoscopic ureterolithotomy for the treatment of large proximal ureteral stones.

Materials and Methods: In this prospective cohort study, the success rate and complications in 52 patients under­going PCNL in Hamadan's Shahid Beheshti Hospital and 55 patients undergoing laparoscopic ureterolithotomy in Tehran's Shahid Labbafinejad Hospital were compared. All patients had large proximal ureteral stones.

Results: In the PCNL group, the mean age was 47.78 ±16.72 years, 75% were male, and 50% of calculi were on the upper right side and the rest on upper left side. The mean duration of surgery was 32 ± 9.4 minutes and success rate 100%. The mean stone size was 18.33 ± 2.63 mm in PCNL group and 21.29 ± 2.18 mm in laparoscopy group which was significantly different (P <.001). In the laparoscopy group, the mean age of patients was 42.92 ± 16.10 years and 83.6% were male. In this group, 46.6% of calculi were on the right side and the rest were on the left side. The mean duration of surgery was 107.43 ± 22.86 minutes and success rate was 100%. There was not a statistically significant association between surgical technique and age, gender, stone location, mean hospital stay length after surgery, degree of hydronephrosis and success rate (P >.05). However, surgery duration was significantly shorter in the PCNL group compared to the laparoscopy group (P <.001) and the decrease in hemoglobin, hematocrit and serum urea level was more pronounced in the PCNL group than in the laparoscopy group.

Conclusion: PCNL and laparoscopic ureterolithotomy met with the same success rate in the treatment of upper large ureteral stones. However, the two methods should be utilized depending on the hospital facilities and equip­ment, surgical team qualifications, and patient conditions.


References

Stoller M. Urinary stone disease in; Smith General Urology. San-Francisco, Mc-Graw-Hill. 18th edition. 2012.

Sofer M, Tavdi E, Levi O, Mintz I, Bar-Yosef Y, Sidi A, et al. Implementation of supine percutaneous nephrolithotomy: a novel position for an old operation. Cent European J Urol. 2017; 70(1):60-65.

Mak DK, Smith Y, Buchholz N, El-Husseiny T. What is better in percutaneous nephrolithotomy - Prone or supine? A systematic review. Arab J Urol. 2016; 14(2):101-7.

Pereira-Arias JG, Gamarra-Quintanilla M, Urdaneta-Salegui LF, Mora-Christian JA, Sánchez-Vazquez A, Astobieta-Odriozola A, et al. Current status of extracorporeal shock wave lithotripsy in urinary lithiasis. Arch Esp Urol. 2017; 70(2):263-287.

Bahílo Mateu P, Budía Alba A, Liatsikos E, Trassierra Villa M, López-Acón JD, de Guzmán Ordaz D, et al. Is extracorporeal shock wave lithotripsy a current treatment for urolithiasis? A systematic review. Actas Urol Esp. 2017; 41(7):426-434.

Jiang H, Yu Z, Chen L, Wang T, Liu Z, Liu J, et al. Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis. Biomed Res Int. 2017; 2017:2035851.

Rassweiler J, Rassweiler MC, Frede T, Alken P. Extracorporeal shock wave lithotripsy: An opinion on its future. Indian J Urol. 2014; 30(1):73-9.

Elmansy HE, Lingeman JE. Recent advances in lithotripsy technology and treatment strategies: A systematic review update. Int J Surg. 2016; 36(Pt D):676-680.

Kroczak T, Scotland KB, Chew B, Pace KT. Shockwave lithotripsy: techniques for improving outcomes. World J Urol. 2017. doi: 10.1007/s00345-017-2056-y.

Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh Urology. 11th Edition. Saunder Co. 2015.

Al-Hunayan A, Khalil M, Hassabo M, Hanafi A, Abdul-Halim H. Management of solitary renal pelvic stone: laparoscopic retroperitoneal pyelolithotomy versus percutaneous nephrolithotomy. J Endourol. 2011; 25: 975-978.

Wang Q, Guo J, Hu H, Lu Y, Zhang J, Qin B, et al. Rigid ureteroscopic lithotripsy versus percutaneous nephrolithotomy for large proximal ureteral stones: A meta-analysis. PLoS One. 2017; 12(2):e0171478.

Moufid K, Abbaka N, Touiti D, et al. Large impacted upper ureteral calculi:A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position. J Endo Urol Ann. 2013; 5(3): 140-146.

Yang T, Liu S, Hu J, Wang L, Jiang H. The Evaluation of Risk Factors for Postoperative Infectious Complications after Percutaneous Nephrolithotomy. Biomed Res Int. 2017; 2017:4832051.

Pillai A, Mathew G, Nachimuthu S, Kalavampara SV. Ventriculo-ureteral shunt insertion using percutaneous nephrostomy: a novel minimally invasive option in a patient with chronic hydrocephalus complicated by multiple distal ventriculoperitoneal shunt failures. J Neurosurg. 2017; 17:1-5.

Hsu CS, Wang CJ, Chang CH, Tsai PC, Chen HW, Su YC. Emergency percutaneous nephrostomy versus emergency percutaneous nephrolithotomy in patients with sepsis associated with large uretero-pelvic junction stone impaction: a randomized controlled trial. Int Braz J Urol. 2017; 43(3):481-488.

Sartorius B, Behnes M, Ünsal M, Hoffmann U, Lang S, Mashayekhi K, et al. Arterial access-site complications after use of a vascular closure device related to puncture height. BMC Cardiovasc Disord. 2017; 16;17(1):64.

Gökce Mİ, Ibiş A, Sancı A, Akıncı A, Bağcı U, Ağaoğlu EA, et al. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones. Urolithiasis. 2017; 45(6):603-608. doi: 10.1007/s00240-017-0977-y.

Liang T, Zhao C, Wu G, Tang B, Luo X, Lu S, et al. Multi-tract percutaneous nephrolithotomy combined with EMS lithotripsy for bilateral complex renal stones: our experience. BMC Urol. 2017; 17(1):15.

Tao J, Sheng L, Zhang HJ, Chen R, Sun ZQ, Qian WQ. Acute Abdominal Compartment Syndrome as a Complication of Percutaneous Nephrolithotomy: Two Cases Reports and Literature Review. Urol Case Rep. 2016; 8:12-4.

Jo JK, Autorino R, Chung JH, Kim KS, Lee JW, Baek EJ, et al. Randomized controlled trials in endourology: a quality assessment. J Endourol. 2013;27(8):1055-60.

Aslzare M, Darabi M.R, Shakiba B, et al. Colonic perforation during percutaneous nephrolithotomy: An -18year experience. J Urol. 2014; 8(5-6):323.

Said SH, Al Kadum Hassan MA, Ali RH, Aghaways I, Kakamad FH, Mohammad KQ. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding. Arab J Urol. 2017; 15(1):24-29.

Cicekbilek I, Resorlu B, Oguz U, Kara C, Unsal A. Effect of percutaneous nephrolithotomy on renal functions in children: assessment by quantitative SPECT of (99m)Tc-DMSA uptake by the kidneys. Ren Fail. 2015; 37(7):1118-21.

Simforoosh N, Aminshararifi A, Nouralizadeh A. Difficulties in laparoscopic surgery for urinary stones. In: Kandari, Gill IS, editors. Difficult conditions in laparoscopic urology.1 st ed, London: Springer-Verlag. 2011; Pp. 305-319.

Wang Y, Zhong B, Yang X, Wang G, Hou P, Meng J. Comparison of the efficacy and safety of URSL, RPLU, and MPCNL for treatment of large upper impacted ureteral stones: a randomized controlled trial. BMC Urol. 2017; 17(1):50.

Simforoosh N, Aminsharifi A. Laparoscopic management in stone disease. Cure Opin Urol. 2013; 23: 169-174.

Demirci D, Gulmez I, Ekmekcioglu O, Karacagil M. Retroperitoneoscopic ureterolithotomy for the treatment of ureteral calculi. Urol Int. 2004;73(3):234-7.

Kim JY, Kang SH, Cheon J, Lee JG, Kim JJ, Kang SG. The usefulness of flexible cystoscopy for preventing double-J stent malposition after laparoscopic ureterolithotomy. BMC Urol. 2017; 15;17(1):44.

Nouira Y, Kallel Y, Bionous MY, Dahmoul H, Horchani A. Laparoscopic retroperitoneal ureterolithotomy :initial experience and review of literature. J Endourol. 2014; 18(6):557-61.

Ergin G, Kirac M, Unsal A, Kopru B, Yordam M, Biri H. Surgical management of urinary stones with abnormal kidney anatomy. Kaohsiung J Med Sci. 2017; 33(4):207-211.

Desai JD. Prospective outcomes of 11-13Ch. ultra-mini percutaneous nephrolithotomy (UMP): A consecutive cohort study. Arch Esp Urol. 2017; 70(1):202-10.

Simforoosh N, Basiri A, Danesh AK, et al. Laparoscopioc management of ureteral calculi: a report of 123 cases. Urol J. 2007; 4(3):138-41.

Skolarikos A, Papatsoris AG, Albanis S, Assimos D. Laparoscopic urinary stone surgery: an update evidence – based review. Urol Res. 2010; 38: 44-337.

Skrepetis K, Doumas K, Siafakas I, et al. Laparoscopic versus open ureterolithotomy. A comparative study. Eur Urol. 2001; 40; 32-36.

Goel A, Hemal AK. Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. Int Urol Nephrol. 2003; 76-35:73.

Basiri A, Simforoosh N, Ziaee A, et al. Retrograde, antegrade, and laparoscopic approaches for the management of large proximal ureteral stones: a randomized clinical trial. J Endourol. 2008; 22:2677-2680.

Mousavi-Bahar SH, Minaei MA. Results of PCNL for renal and upper ureteral stones without fluoroscopy. Sci J Hamadan Univ Med Sci. 2003; 10:35-8.

Mousavi Bahar SH, Babolhavaeji H, Mani Kahsani Kh, Zand-Vakili H. Percutaneous Nephrolithotomy in the management of pediatric renal calculi. J Med Counc Iran. 2006; 24(3):271-8.

Mousavi Bahar SH, Babolhavaeji H, Mani Kahsani Kh. Study of response rate to PCNL therapy for renal and upper ureteral stones. J Tabriz Univ Med Sci. 2007; 29(1): 103-9.

Noorbala H. Laparoscopic ureterolithotomy: Results and report of transperitoneal TUL (Laparoscopic assisted). JAUMS. 2006; 4(3):939-42.

Soufi Majidpour H, Yousefinejad V. Percutaneous management of urinary calculi in horseshoe kidneys. Urol J. 2008; 5(3):188-91.

Zhao C, Yang H, Tang H, Xia D, Xu H, Chen Z, et al. Comparison of laparoscopic stone surgery and percutaneous nephrolithotomy in the management of large upper urinary stones: a meta‑analysis. Urolithiasis. 2016; 44(6):479-90.

Aminsharifi A, Irani D, Masoumi M , Goshtasbi B, Aminsharifi A, Mohamadian R. The management of large staghorn renal stones by percutaneous versus laparoscopic versus open nephrolithotomy: a comparative analysis of clinical efficacy and functional outcome. Urolithiasis. 2016; 44(6):551-7.

Lopez M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010; 25(1):49–59.




DOI: http://dx.doi.org/10.22037/uj.v0i0.4538

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