title: Comparison of safety and efficacy of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in patients with renal pelvic stones: a randomized clinical trial.
abstract: OBJECTIVE
  A randomized clinical trial was designed to compare the efficacy, success rate and surgical complications of percutaneous nephrolithotomy (PCNL) and laparoscopic pyelolithotomy (LP).
  
  
  METHODS
  Sixty patients with renal pelvic stones larger than 2 cm were randomly divided into two groups of LP and PCNL. All patients were followed up to three months after surgery using renal diethylenetriamine&shy;pentaaceticacid (DTPA) scan and determining the glomerular filtration rate (GFR).
  
  
  RESULTS
  Mean operation time (149 &plusmn; 31 vs. 107 &plusmn; 26 min) and mean hospital stay (3.4 vs. 2.16 days) were significantly higher in LP, but mean hemoglobin drop (0.85 vs. 1.88 g/dL) and the rate of blood transfusion were significantly lower. Stone free rate was 90% and 86.6% for LP and PCNL, respectively (P =.59), while the changes in GFR were not statistically significant 3 days after surgery between two groups. Those in LP group showed better improvement in GFR at three months postoperatively. Improvement of the affected split kidney function was significantly higher in LP group (P =.04). No major complications were observed in both groups according to Clavien grading system.
  
  
  CONCLUSIONS
  PCNL remains the gold standard treatment for most large kidney stones, nevertheless, laparoscopic pyelolithotomy can be considered for selected cases especially in whom maximal preservation of renal function is &nbsp;necessary.&nbsp;
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Tabibi
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Akbar
authors.initials: A
authors.lastname: Nouralizadeh
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Arab
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Gholam Hossein
authors.initials: GH
authors.lastname: Rezaeetalab
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Hosseini Sharifi
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran. mhsoltani60@gmail.com.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology / Q000628:therapy; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000379:methods; D001810:Blood Volume; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery; D007682:Kidney Pelvis / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods; D061646:Operative Time; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome