Percutaneous nephrostolithotomy vs open surgery for renal calculi. A comparative study
G. M. Preminger, R. V. Clayman, S. W. Hardeman, J. Franklin, T. Curry and P. C. Peters
To evaluate the impact of the percutaneous removal of renal calculi we
compared 41 patients who had undergone open renal surgery to 88 patients
who had a one- or two-stage percutaneous nephrostolithotomy for symptomatic
urolithiasis. The two groups were similar with regard to stone size, stone
location, treatment success, and complication rates. However, for patients
with calculi 2.5 cm or smaller in diameter, the percutaneous procedure
resulted in lower postoperative morbidity, more rapid convalescence, less
hospital cost, and greater patient satisfaction. For patients with calculi
larger than 2.5 cm in diameter, the percutaneous approach was slightly more
expensive than open surgery but resulted in a markedly shortened
convalescent period. In our experience, percutaneous nephrostolithotomy
performed in a single stage under assisted local anesthesia was the most
efficacious and least expensive of the percutaneous approaches.