5 Year Outcome Comparing between Lower Pole and Non-Lower Pole Approach Percutaneous Nephrolithotripsy

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5 Year Outcome Comparing between Lower Pole and Non-Lower Pole Approach Percutaneous Nephrolithotripsy

Journal Title: Vajira Medical Journal: Journal of Urban Medicine - Year 2022, Vol 66, Issue 3

Abstract

Objectives: Percutaneous Nephrolithotomy (PCNL) is considered to be the principal treatment for large kidney stones. Nephrolithotripsy approaches—namely the Lower Pole Approach and the Non-Lower Pole Approach—are widely referred to and utilized today. Currently, there is no consensus as to which approach yields the best treatment outcome or results in lowest level of complication. This study reports both treatment outcome and complications from information acquired from patients, with all sizes of kidney stones, who received PCNL treatment under both techniques at Vajira Hospital. Methods: According to the information collected in the past 5 years, there were 72 patients who had been treated with PCNL. The information was collected in terms of stone sizes, treatment techniques, and methods. In order to compare the treatment outcome between the Lower Pole Approach and Non-Lower Pole Approach, operative time and information gathered during follow-up sessions, including complications and hospital length of stay were analyzed. Results: According to the results, 37 out of 72 patients (51.4%) underwent the Lower Pole Approach, and 35 out of 72 patients (48.6%) underwent the Non-Lower Pole Approach. The results revealed that the stone-free rate in the Lower Pole Approach group was indifferent to that in the Non-Lower Pole Approach group (56.8% vs. 54.3% respectively, level of confidence p=0.776), and so was the average operative time in minutes (151.62±40.43 in the Lower Pole Approach group vs. 148.00±60.34 in the Non-Lower Pole Approach group, p=0.765). There were more but milder complications in the Lower Pole Approach group compared to the Non-Lower Pole Approach group (16.2% vs. 5.7% respectively, p=0.033), latter of which resulted in one case of intrathoracic complication. Moreover, it was discovered that the average length of stay in days of the Lower Pole Approach group was significantly shorter than that of the Non-Lower Pole Approach group (6.38±3.09 vs 8.06±4.14 respectively, p=0.048). Conclusion: The kidney stone treatment of the Lower Pole Approach has equal stone-free rate as the Non-Lower Pole Approach but has a higher rate of mild complications.

Authors and Affiliations

Jirawee Jantaranukul Thitawat Wongampornpat

Keywords

5 Year Outcome Comparing between Lower Pole and Non-Lower Pole Approach Percutaneous Nephrolithotripsy

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EP ID EP723865
DOI http://dx.doi.org/10.14456/vmj.2022.21
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