ABSTRACT

To compare, retrospectively, results of cases undergoing pyelolithotomy and percutaneous nephrolithotomy (PNL) for pelvis renalis (PR) calculi in our clinic.

Sixty patients had undergone PNL between December 2004-June 2006 and 46 patients undergone pyelolithotomy between January 2005-August 2006 for PR calculi. Percutaneous intervention was performed under C-armed flouroscopy on patients in prone position. A subcostal flank approach was used for pyelolithotomy.

Mean age was 44±11 and 42±8 years for PNL and pyelolithotomy groups, respectively. Mean operative time was 140.6 minutes in PNL group. Stone-free rate was 93.33% and when residual fragments<4mm accepted clinically insignificant increased to 98.33% in PNL group. Differences between pre and postoperative hemoglobin and hematocrit were 1.34 gr/dl and 4.22, respectively. Blood transfusion required in 3 (5%) patients during early postoperative period. A postoperative fever of 39.5°C occured in one patient. Mean operative time was 165.3 minutes in pyelolithotomy group. Stone-free rate was 100%. Differences between pre and postoperative hemoglobin and hematocrit were 1.17 gr/dl and 3.42, respectively. Blood transfusion during early postoperative period required in 2 (4.35%) patients. A double-j catheter was inserted in 19 patients. Mean duration for nephrostomy removal and mean hospital stay in PNL group were 2.30 and 3.50 days, respectively. Mean duration for drain removal and mean hospital stay in pyelolithotomy group were 3.45 and 5.20 days, respectively.

Indications of open stone surgery have been changed and it became to be used only for difficult cases. Our results show that PNL is successful in treatment of PR calculi.

Keywords: Pelvis renalis calculi, PNL, pyelolithotomy