Comparison of antegrade percutaneous versus retrograde ureteroscopic lithotripsy for upper ureteric calculus for stone clearance, morbidity, and complications
| العنوان: | Comparison of antegrade percutaneous versus retrograde ureteroscopic lithotripsy for upper ureteric calculus for stone clearance, morbidity, and complications |
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| المؤلفون: | Bhat, Amilal, Singh, Vikash, Bhat, Mahakshit, Khandelwal, Nikhil, Bhat, Akshita |
| المصدر: | Indian Journal of Urology, Vol 35, Iss 1, Pp 48-53 (2019) Indian Journal of Urology : IJU : Journal of the Urological Society of India |
| بيانات النشر: | Wolters Kluwer Medknow Publications, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Original Article, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923 |
| الوصف: | Introduction: The optimal management of upper ureteric calculus remains controversial. We compare the outcomes of antegrade percutaneous ureterolithotripsy (APCUL) with retrograde ureteroscopic lithotripsy (URSL) for upper ureteric calculus with respect to stone clearance, morbidity, and complication rates. Materials and Methods: This prospective study was carried out from December 2014 to June 2016. A total of 117 patients with upper ureteric calculus sized (10–20) mm who underwent APCUL or URSL were included in the study. Results: APCUL and URSL were performed in 64 and 53 patients, respectively. The mean age and stone size were comparable between the two groups. The stone clearance rate at 1-month follow-up was 93.75% in the antegrade group and 81.13% in the retrograde group (P = 0.036). Mean anaesthesia time was significantly longer for the APCUL group while the actual mean operative time was significantly longer for the URSL group (P < 0.001). The overall complication rate was higher in antegrade group (P = 0.804), whereas most of the major complications (Clavien Grade III or more) occurred only in the URSL group (P = 0.007). Blood transfusion was required only in the APCUL group (7.8% versus 0%; P = 0.50). In the URSL group, stone retropulsion occurred in four patients, of which three subsequently required shock wave lithotripsy and one required percutaneous nephrolithotomy in a second sitting. Conclusion: APCUL has better stone-free rates as compared to URSL for an upper ureteric calculus of size 10–20 mm. Although the postoperative minor complications are higher in the antegrade group, severe complications occurred only in the retrograde group. Hence, antegrade approach can be considered as the preferred option to achieve better stone clearance in a single sitting with acceptable morbidity and complication rates. |
| اللغة: | English |
| تدمد: | 1998-3824 0970-1591 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::2fc44ecd7998525b3b2da74a3671102dTest http://www.indianjurol.com/article.asp?issn=0970-1591;year=2019;volume=35;issue=1;spage=48;epage=53;aulast=BhatTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.pmid.dedup....2fc44ecd7998525b3b2da74a3671102d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19983824 09701591 |
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