Abstract
Background Large renal pelvic stones can be effectively managed with laparoscopic pyelolithotomy.
The aim of this study was to compare the surgical outcomes of laparoscopic pyelolithotomy
versus open surgery for the treatment of large renal pelvic stones.
Materials and Methods This prospective comparative study was performed at the Sher-i-Kashmir Institute
of Medical Sciences Medical College and Hospital over a period of 8 years. Using computer-generated
random numbers, the patients were randomized into two groups: group A received laparoscopic
pyelolithotomy, while group B had open pyelolithotomy. The data was collected and
analyzed using SPSS software 22.
Results Among 74 patients who met the inclusion criteria, the mean age was 39.18 years with
66.21% being males and a male:female ratio of 1.96. Forty-one (55.41%) patients had
open surgery and 33 (44.59%) had laparoscopic pyelolithotomy. The difference in mean
operative time of laparoscopy (117.66 minutes) and open (78.13 minutes) surgery was
statistically significant (p = 0.05). The mean blood loss was significantly lower in the laparoscopic pyelolithotomy
group (62.12 mL) than in the open group (92.07 mL) (p = 0.009). The difference in mean hospital stay between the open and laparoscopic
groups was significant (p = 0.02). In both laparoscopy and open surgery, we observed a 100% stone-free rate
at the end of 1 month. None of our patients expired during the study period.
Conclusion Laparoscopic pyelolithotomy is a promising alternative to traditional open and other
endourological techniques, with encouraging results. Despite its technical difficulty,
it yields high stone-free rates and low postoperative morbidity.
Keywords
laparoscopy - open surgery - pyelolithotomy - renal pelvic stones - renal stones
