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Percutaneous Nephrostolithotomy vs Open Surgery for Renal CalculiA Comparative Study
Glenn M. Preminger, MD;
Ralph V. Clayman, MD;
Stephen W. Hardeman, MD;
Joe Franklin, MD;
Thomas Curry, MD;
Paul C. Peters, MD
JAMA. 1985;254(8):1054-1058.
Abstract
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.
(JAMA 1985;254:1054-1058)
Author Affiliations
From the Departments of Surgery (Urology) (Drs Preminger, Clayman, Hardeman, and Peters) and Radiology (Drs Franklin and Curry), University of Texas Health Science Center, Southwestern Medical School, Dallas.
Footnotes
Reprint requests to Division of Urology, University of Texas Health Science Center, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Preminger).
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