Outcome of Percutaneous Nephrolithotomy by Using Pneumatic Lithotripsy Alone and In Combination with Ultrasonic...

Area of Science:

• Urology
• Endourology
• Nephrolithiasis Treatment

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large kidney stones.
• Advancements in endoscopic technology and lithotripter techniques enhance PCNL success rates and reduce complications.
• New lithotripter methods improve stone fragmentation and clearance efficiency.

Purpose of the Study:

• To compare the outcomes of PCNL using pneumatic lithotripsy versus combined pneumatic and ultrasonic lithotripsy.
• To evaluate the efficacy of different lithotripsy methods in terms of operative time, blood loss, and stone clearance.
• To determine if combined lithotripsy offers advantages over pneumatic lithotripsy alone in PCNL.

Main Methods:

• A quasi-experimental study involving 60 patients undergoing PCNL.
• Group A (30 patients): PCNL with pneumatic lithotripsy.
• Group B (30 patients): PCNL with combined pneumatic and ultrasonic lithotripsy.
• Comparison of stone size, operative time, hospital stay, hemoglobin loss, ancillary procedures, and stone clearance rates.

Main Results:

• Mean operative time was significantly shorter for combined lithotripsy (57.3 min) compared to pneumatic alone (67.5 min) (p<0.05).
• Mean postoperative hemoglobin drop was significantly lower with combined lithotripsy (1.12 g/dL) versus pneumatic alone (1.37 g/dL) (p<0.05).
• No significant differences were observed in stone size, hospital stay, or stone-free rates between the groups.

Conclusions:

• Combined pneumatic and ultrasonic lithotripsy demonstrates superior efficacy in PCNL compared to pneumatic lithotripsy alone.
• This combined approach significantly reduces operative time and blood loss during PCNL.
• Combined lithotripsy is an effective advancement for treating large kidney stones with PCNL.