Laparoscopic transperitoneal pyelolithotomy as an alternative to percutaneous nephrolithotomy for stones in anomalous kidneys: a preliminary report

Objective: We report our experience with laparoscopic transperitoneal pyelolithotomy (LTPL) and percutaneous nephrolithotomy (PCNL) in the management of patients with calculi in anomalous kidneys.

Materials and methods: Data from 11 patients who underwent LTPL and 13 patients who underwent PCNL for kidney stones between May 2006 and August 2010 were retrospectively analyzed. A flexible nephroscope and holmium:YAG laser lithotripsy were used for stone clearance in 2 patients in LTPL group and 3 patients in PCNL group.

Results: The two groups were similar in age, body mass index, and sex; however, mean stone size was slightly greater in the PCNL group, although this difference was statistically insignificant. Mean operative time and hospitalization time were significantly higher in the LTPL group whereas estimated blood loss and mean postoperative analgesic requirement were significantly reduced in the LTPL group. There were no statistically significant differences in terms of stone size, complication rates, blood transfusion rates or stone-free status. There were no residual fragments in either group, and complete clearance was achieved in all the cases.

Conclusion: With an experienced surgical team, most cases of stone disease in congenitally abnormal kidneys can be treated laparoscopically with low postoperative morbidity and complication rates, a short convalescence time, and good functional results.