Management of solitary renal pelvic stone: laparoscopic retroperitoneal pyelolithotomy versus percutaneous...

Percutaneous nephrolithotomy (PCNL) is considered the main management option for large single renal pelvic stones; however, laparoscopic retroperitoneal pyelolithotomy (LRP) can be used as an alternative management procedure. We compare both procedures in the management of solitary large renal pelvic stones.

Between June 2002 and July 2010, 105 patients with solitary large renal pelvic stones were selected and randomly divided into two groups; group 1 included 55 patients who were treated by LRP and group 2 included 50 patients who were treated by PCNL. The differences between the two procedures were compared and analyzed.

There was no difference between the two groups regarding patient demographics and stone size. There was no statistically significant difference between LRP and PCNL regarding mean estimated blood loss (166.4±98.3  mL vs 178±102.4  mL), mean hospital stay (4.5±1.9 d, vs 4.4±1.4 d), mean time of postoperative analgesia (2.2±0.9 d vs 2.4±0.9 d), rate of postoperative blood transfusion (5.5% vs 6%), and stone-free rate (100% vs 96%). The mean operative time was significantly longer in the LRP group (130.6±38.7  min vs 108.5±18.7  min), respectively. There was only one (1.8%) case from the laparoscopy group converted to open surgery because of uncontrolled bleeding.

RLP is a suitable surgical technique for patients with large renal pelvic stones but with good selection of cases; however, PCNL remains the standard treatment in most cases.