| Autor: |
Mir, Mujahid Ahmad, Hassan, Tajamul, Malik, Sajad Ahmad, Wani, Mohammad Saleem, Hamid, Arif, Ahmed, Yaser, Para, Sajad Ahmad, Khawaja, Abdul Rouf |
| Předmět: |
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| Zdroj: |
JK Practitioner; Oct-Dec2022, Vol. 27 Issue 4, p11-15, 5p |
| Abstrakt: |
Background: Management of moderate sized (1-2 cm) lower calyceal kidney stone continues to be an unsettled question. We tried to study the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) for lower calyceal kidney stones 1-2 cm in size. Materials and Methods: A prospective observational study which included patients with lower calyceal stones sized 1-2 cm, excluding, those with bilateral or radiolucent kidney stones, bleeding diathesis or pyonephrosis. Selected patients were grouped into Extracorporeal Shock Wave Lithotripsy (ESWL) as Group A and Percutaneous nephrolithotomy (PCNL) as Group B with due consideration of their calyceal anatomy. Patients were followed up by abdominal ultrasound and plain X-ray (NCCT if indicated) till stone clearance. Hospital stay, operative duration, outcomes and complications were recorded for each group. Results: The patient characteristics of both groups were comparable except smoking history and median stone size. Among a total of 144 selected patients, 46.6% versus 25 % of the patients included in Group A were smokers or had a recent history of smoking. The median stone size differed significantly between the two groups (13 mm versus 18 mm). The stone free rate (SFR) was 71.7% and 85.7% for Groups A and B respectively (P < 0.05). Among the 43 patients with treatment success from Group A, 11(25.6%) patients needed second and 4(9.3%) patients the third session of ESWL. The complication rate was 10.7% (Clavian Dindo 2) for Group B patients. The mean fluoroscopy time, mean operative time and mean hospital duration were 210.01 seconds versus 133.6 seconds(p=0.011), 42.1 minutes versus 67.5 minutes (p=0.001) and 3.75 hours versus 92.3 hours (p=0.010) respectively in Group A and Group B patients. Conclusion: Comparing with ESWL, PCNL is safe and has better stone free rate with a low retreatment rate for lower calyceal stones sized 10-20 mm. However, PCNL has more operative time, blood transfusion rate and requires longer hospital stay. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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