Volume : 09, Issue : 01, January – 2022

Title:

10.TO COMPARE THE FREQUENCY OF STONE CLEARANCE IN PATIENTS UNDERGOING ULTRASONIC LITHOTRIPSY WITH PNEUMATIC LITHOTRIPSY FOR THE TREATMENT OF LARGE RENAL CALCULI.

Authors :

Shoukat Ali, Maqbool Jabbar, Rabeea Saleem, Sunil Kumar, Shireen Pyarali, Pardeep Kumar, Manzoor Hussain

Abstract :

Introduction: Percutaneous approach to kidney was first described in 1955 by Goodwin and colleague.1 This approach, with the insertion of nephrostomy tube, was used to provide drainage for obstructed renal unit. This example led to recognition that same access could also be used as a working channel for the percutaneous removal of the kidney stone. Thus began era of percutaneous renal surgery.2 The indications for PCNL have gradually changed with improvement of techniques and with the introduction of extracorporeal shockwave lithotripsy (SWL) into clinical practice .3 PCNL is generally a safe treatment option and associated with a low but specific complications rate. Many complications develop from the initial puncture with injury of surrounding organs (e.g. colon, spleen, liver, pleura, and lung). Other specific complications include postoperative bleeding and fever.5,6
Objective: To compare the frequency of stone clearance in patients undergoing ultrasonic lithotripsy with pneumatic lithotripsy for the treatment of large renal calculi.
Study Design: Randomized Clinical Trial.
Setting: The study was completed at department of Urology, Sindh Institute of Urology and Transplantation Karachi.
Duration Of Study: Six months after approval of synopsis. (Jan, 2018 to July 2018)
Subject And Methods: After approval from research evaluation unit of college of Physicians and Surgeons of Pakistan (CPSP) and ethical committee of the hospital, patients who were present in urology department of Sindh Institute of Urology and Transplantation fulfilling the inclusion criteria were included in this study until the required sample size of 128 patients is completed. An informed consent was taken from all patients before including them in this study. Patients were divided into two groups using lottery method. Group I: Patients pneumatic lithotripsy was used for the treatment of renal calculi and in Group II patient’s ultrasonic lithotripsy was used. Both of these procedures were done by senior. Post-procedural X-ray KUB was done 3 days after the surgical procedure to determine the stone clearance in every patient.
Results: 62(96.9%) patients had stone free rate in group ultrasonic lithotripsy, 51(79.7%) patients had stone free rate in group Pneumatic lithotripsy overall 113(88.3%) patients had stone free rate in both groups.
Conclusion: , Pneumatic and ultrasonic lithotripters were compared, and both of them were found to be effective, safe, and reliable management modalities. However, the ultrasonic lithotripter provided higher stone-free rates.
Key Words: Percutaneous Nephrolithotomy (PCNL), Stone free rate, large Renal Stones, pneumatic lithotripsy, ultrasonic lithotripsy.

Cite This Article:

Please cite this article in press Shoukat Ali et al, To Compare The Frequency Of Stone Clearance In Patients Undergoing Ultrasonic Lithotripsy With Pneumatic Lithotripsy For The Treatment Of Large Renal Calculi., Indo Am. J. P. Sci, 2022; 09(01).

Number of Downloads : 10

References:

1. Fernström I, Johansson B. Percutaneous pyelolithotomy. a new extraction technique. Scandinavian J Urol Nephrol. 1976;10(3):257.
2. Turk C, Knoll T, Petrik A, Sarika K, Seitz C, Straub M. Guidelines on urolithiasis. European Assoc Urol. 2014;25-8.
3. Sountoulides P, Metaxa L, Cindolo L. Is computed tomography mandatory for the detection of residual stone fragments after percutaneous nephrolithotomy? J Endourol. 2013;27(11):1341-8.
4. Cho C, Yu JH, Sung LH, Chung JY, Noh CH. Comparison of percutaneous nephrolithotomy using pneumatic lithotripsy (lithoclast®) alone or in combination with ultrasonic lithotripsy. Korean J Urol. 2010;51(11):783-7.
5. Karakan T, Diri A, Hascicek AM, Ozgur BC, Ozcan S, Eroglu M. Comparison of ultrasonic and pneumatic intracorporeal lithotripsy techniques during percutaneous nephrolithotomy. Sci World J. 2013;2013.
6. Kingo PS, Ryhammer AM, Fuglsig S. Clinical experience with the swiss lithoclast master in treatment of bladder calculi. J Endourol. 2014;28(10):1178-82.
7. Rosa M, Usai P, Miano R, Kim FJ, Agrò EF, Bove P, et al. Recent finding and new technologies in nephrolithiasis: a review of the recent literature. BMC Urol. 2013;13(1):1-8.
8. Karakan T, Diri A, Hascicek AM, Ozgur BC, Ozcan S, Eroglu M. Comparison of ultrasonic and pneumatic intracorporeal lithotripsy techniques during percutaneous nephrolithotomy. Sci World J. 2013;2013: 604361.
9. Al-Hiari AM, Al-Naser M, Al-Sarhan M, Maslamani A, Rabab’ah A, Saideh N, et al. A comparison between ultrasonic and pneumatic lithotripsy in percutaneous nephrolithotomy–Our experience in Prince Hussein Bin Abdallah the II center of urology and organ transplantation. Int J Med Invest. 2015;4(4):349-51.
10. Stoller ML, Wolf JS Jr, St Lezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994;152:1977-81.
11. Alan J. Wein, Louis R. Kavoussi, Andrew C. Novick, Alan W. Partin, Craig A. Peters. Campbell-Walsh Urology. Tenth ed. Philadelphia, Pennsylvania: Elsevier, Saunders; 2012
12. Begun FP. Modes of intracorporeal lithotripsy : ultrasound versus electrohydraulic lithotripsy versus laser lithotripsy. Semin Urol. 1994; 12 :39 – 50.
13. Hoffman R, Olbert P , Weber J, Wille S, Varga Z. Clinical experience with a new ultrasonic and lithoClast combination for percutaneous litholapaxy. BJU Int. 2002 ; 90 : 16 – 19.
14. Lehman DS, Hurby GW, Phillips C, Venkatesh R, Best S, Monga M, et al. Prospective randomized comparison of a combined ultrasonic and pneumatic lithotrite with a standard ultrasonic lithotrite for percutaneous nephrolithotomy. J Endourol. 2008 ; 22 : 285 – 289.
15. Hoffman R, Weber J, Heidenreich A, Varga Z, Olbert P. Experimental studies and first clinical experience with a new lithoclast and ultrasound combination for lithotripsy. Eur Uro. 2002 ; 42 : 376 – 381.
16. Tolga K, Akif D, Ahmet MH, Berat CO, Serkan O, Muzzafer E. Comparison of ultrasonic and pneumatic intracorporeal lithotripsy techniques during percutaneous nephrolithotomy. The scientific world journal. Volume 2013 ( 2013 ), http://dx.doi.org/10.1155/2013/604361
17. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10:257–259.
18. Marguet CG, Springhart WP, Tan YH, Patel A, Undre S, Albala DM, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int. 2005;96:1097–1100.
19. Begun FP. Modes of intracorporeal lithotripsy: ultrasound versus electrohydraulic lithotripsy versus laser lithotripsy. Semin Urol. 1994;12:39–50.
20. Brannen GE, Bush WH, Correa RJ, Gibbons RP, Elder JS. Kidney stone removal: percutaneous versus surgical lithotomy. J Urol. 1985;133:6–12.