Comparison of surgical outcomes between laparoscopic pyelolithotomy and percutaneous nephrolithotomy in patients with multiple renal stones in various parts of the pelvocalyceal system.

Purpose: To evaluate surgical outcomes of laparoscopic pyelolithotomy (LP) and percutaneous nephrolithotomy (PCNL) in managing multiple renal stones in various parts of the pelvocalyceal system.

Subjects And Methods: From February 2004 to December 2011, 45 patients underwent LP, and 39 underwent PCNL for treatment of pelvic stone(s) with calyceal stone(s). Differences in demographics, perioperative data, and complications were compared between LP and PCNL patients. The primary end point in this study was the stone-free rate in a single session.

Results: Stone-free rates were 91.1% and 64.1% in the LP and PCNL groups, respectively (P=.003). Mean operation time was longer in the LP group (P<.001). Mean change in hemoglobin level (P<.001) as well as postoperative analgesics usage (P=.022) was significantly better in the LP group. However, mean estimated blood loss (P=.112), mean change in creatinine level (P=.172) and estimated glomerular filtration rate (P=.395), and mean length of hospitalization (P=.842) were similar in both groups. The PCNL group had more overall complications.

Conclusions: LP was safer and more effective than PCNL according to our study. Therefore, LP may be a feasible modality in managing multiple complex renal stones in various parts of the pelvocalyceal system.