title: Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones.
abstract: BACKGROUND
  The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL).
  
  
  METHODS
  This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm(2) or greater were included. Group 1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed.
  
  
  RESULTS
  There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 ± 12.25 [range: 52.75-77.25] vs. 180 ± 20.74 [range: 159.26-200.74] mL, p ≤ 0001), mean hospital stay (2.3 ± 0.64 [range: 1.66-2.94] vs. 3.7 ± 1.4 [range: 2.3-5.1] days, p ≤ 0.006), rate of postoperative blood transfusion (0% vs. 4.8%, p ≤ 0.0024), and stone-free rate (80% vs. 78.6%, p ≤ 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 ± 22.11 [range: 108.89-153.11) vs. 51.19 ± 24.39 [range: 26.8-75.58] min, p ≤ 0001), respectively.
  
  
  CONCLUSIONS
  Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones.
authors.affiliation: Al-Azhar Urology Department, Assiut, Egypt;
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Haggag
authors.forename: Gamal
authors.initials: G
authors.lastname: Morsy
authors.forename: Magdy M
authors.initials: MM
authors.lastname: Badr
authors.forename: Abdel Baset A
authors.initials: AB
authors.lastname: Al Emam
authors.forename: Mourad
authors.initials: M
authors.lastname: Farid
authors.forename: Mohamed
authors.initials: M
authors.lastname: Etafy