Percutaneous Nephrolithotomy for Staghorn Stones: A Randomized Trial Comparing High Power Holmium Laser versus Ultrasonic Lithotripsy

BJU International
Ahmed R El-NahasAhmed A Shokeir

Abstract

To compare high power holmium Laser lithotripsy (HP-HLL) and ultrasonic lithotripsy (US-L) in disintegration of staghorn stones during percutaneous nephrolithotomy (PNL). A non-inferiority randomized controlled trial was conducted between August 2011 and September 2014. Inclusion criteria were patients' age >18 years who had complete staghorn stones (branching to the three major calyces) without contraindications to PNL. Eligible patients were randomized between 2 groups (HP-HLL and US-L). A Standard PNL in prone position was performed for all patients. The only difference between treatment groups was method of stone disintegration. In the first group, Laser power of 40-60 Watt (2 Joules, 20-30 Hertz) was used to pulverize the staghorn stone into very small fragments that can pass through the Amplatz sheath with the irrigation fluid. Ultrasonic lithotripsy with suction of the fragments was used in the second group. The primary outcome (stone-free rate) was evaluated with non-contrast CT after 3 months. Secondary outcomes; complication, blood transfusion, operative time and haemoglobin deficit were compared. Outcome assessor was blinded to the treatment arm. The study included 70 patients (35 in each group). The base line charac...Continue Reading

References

May 10, 2005·The Journal of Urology·Glenn M PremingerUNKNOWN AUA Nephrolithiasis Guideline Panel)
Dec 21, 2010·BJU International·Ahmed R El-NahasMahmoud R El-Kenawy
Jul 22, 2011·Journal of Endourology·Mahesh DesaiJean Rosette On Behalf Of The Croes Pcnl Study Group
Jan 24, 2012·The Journal of Urology·Jason SeaJoel M H Teichman
Feb 5, 2013·Urology·Sarah L Hecht, J Stuart Wolf

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Citations

Nov 9, 2016·International Journal of Surgery·Thomas Tailly, John Denstedt
Oct 21, 2016·Journal of Endourology·Casey A DauwJames E Lingeman
Apr 17, 2018·Renal Failure·Akif Diri, Banu Diri
Dec 6, 2017·Urolithiasis·Peter Alken
Sep 16, 2019·World Journal of Urology·Xiangkun WuYongda Liu
Feb 22, 2018·Scandinavian Journal of Urology·Tarik Emre SenerOlivier Traxer
Apr 23, 2020·Current Urology Reports·Thomas ReevesBhaskar K Somani
May 19, 2018·Current Urology Reports·Peter Kronenberg, Bhaskar Somani

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