TY - JOUR
T1 - Comparative analysis of retro vs. transperitoneal laparoscopic pyelolithotomy for large renal stones
AU - Pakmanesh, Hamid
AU - Zahir, Mazyar
AU - Farshi, Alireza
AU - Aminsharifi, Alireza
AU - Borumandnia, Nasrin
AU - Salari, Ali
AU - Setaresobh, Shadi
AU - Kashi, Amir Hossein
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
PY - 2024/12
Y1 - 2024/12
N2 - The objective of this study is to compare the outcomes and complications of retroperitoneal and transperitoneal laparoscopic pyelolithotomy (RLP and TLP, respectively) in the treatment of large kidney stones. In this retrospective cohort effort, data of all patients who underwent laparoscopic pyelolithotomy for renal pelvic stone (N = 273) in three referral urology hospitals were retrieved. Operation duration, length of hospital stay, postoperative stone-free rate, hemoglobin (Hb) and creatinine (Cr) changes and complications were compared between the two groups before and after propensity score matching. A total of 199 TLP and 74 RLP cases were examined. Stone size was significantly higher in the TLP vs. RLP group (29.8 ± 10.9 vs. 26.5 ± 8.8 mm; P =.022). Length of operation and hospital stay were comparable (P =.672 and P =.396, respectively). Rate of conversion to open surgery, postoperative blood transfusion rate, postoperative urinary leakage, postoperative stone-free rate, Hb drop and Cr change were similar between the two groups (P =.348, 0.190, 0.828, 0.411, 0.780 and 0.134, respectively). Postoperative fever was significantly more prevalent in TLP compared to RLP (21.6% vs. 0.0%, respectively; P <.001). Propensity score matched analyses showed similar results in all aspects; particularly demonstrating higher postoperative fever in TLP compared to RLP (18.9% vs. 0.0%, respectively; P <.001). RLP can be considered as an alternative to TLP; especially owing to a lower chance of postoperative fever.
AB - The objective of this study is to compare the outcomes and complications of retroperitoneal and transperitoneal laparoscopic pyelolithotomy (RLP and TLP, respectively) in the treatment of large kidney stones. In this retrospective cohort effort, data of all patients who underwent laparoscopic pyelolithotomy for renal pelvic stone (N = 273) in three referral urology hospitals were retrieved. Operation duration, length of hospital stay, postoperative stone-free rate, hemoglobin (Hb) and creatinine (Cr) changes and complications were compared between the two groups before and after propensity score matching. A total of 199 TLP and 74 RLP cases were examined. Stone size was significantly higher in the TLP vs. RLP group (29.8 ± 10.9 vs. 26.5 ± 8.8 mm; P =.022). Length of operation and hospital stay were comparable (P =.672 and P =.396, respectively). Rate of conversion to open surgery, postoperative blood transfusion rate, postoperative urinary leakage, postoperative stone-free rate, Hb drop and Cr change were similar between the two groups (P =.348, 0.190, 0.828, 0.411, 0.780 and 0.134, respectively). Postoperative fever was significantly more prevalent in TLP compared to RLP (21.6% vs. 0.0%, respectively; P <.001). Propensity score matched analyses showed similar results in all aspects; particularly demonstrating higher postoperative fever in TLP compared to RLP (18.9% vs. 0.0%, respectively; P <.001). RLP can be considered as an alternative to TLP; especially owing to a lower chance of postoperative fever.
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U2 - 10.1007/s00240-024-01640-w
DO - 10.1007/s00240-024-01640-w
M3 - Article
C2 - 39382752
AN - SCOPUS:85206047708
SN - 2194-7228
VL - 52
JO - Urolithiasis
JF - Urolithiasis
IS - 1
M1 - 137
ER -