A Comparative Study Between Pneumatic and Laser Lithotripsy for Proximal Ureteric Calculus

  • Rajan Koju Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal. https://orcid.org/0000-0001-6329-1691
  • Hemnath Joshi Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.
  • Sujan Makaju Shrestha Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.
  • Robin Karmacharya Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.
  • Narendra Shalike Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.
Keywords: Laser lithotripsy, Pneumatice lithotripsy, Ureteric calculus

Abstract

Introduction: There are various modalities of breaking urinary tract calculus. The aim of this study was to compare outcome between laser and pneumatic lithotripsy in patients with upper ureteric calculus in terms of stone free rate, proximal migration and complication. Methods: This was a prospective comparative study done in 210 patients with upper ureteric calculus. The patients were randomized into two groups (Laser Lithotripsy and Pneumatic Lithotripsy) from April 2018 to June 2019. The main objective of both the procedures was to break stone into particles less than 3 mm which was confirmed by X-ray KUB and ultrasonography of abdomen and pelvis after six weeks and to compare effectiveness in terms of immediate stone free rate, proximal migration, operative duration and post-operative complication. Results: There was no difference in age, gender and stone size in both groups. Immediate stone free rate was 99.05% in Laser Lithotripsy and 76.19% in Pneumatic Lithotripsy (p value<0.001). Proximal migration in Laser Lithotripsy was 0.95% and 23.81% in Pneumatic Lithotripsy (p<0.001). There was significantly prolonged operative duration in Pneumatic Lithotripsy (14.7±4.77 min vs 13.31±3.24 in Laser Lithotripsy, p=0.014). Complications were more in Pneumatic Lithotripsy group, which was statistically significant (p=0.017). Conclusion: Both pneumatic and laser lithotripsy are effective and safe modalities for treating upper ureteric calculus, however laser has less chances of proximal migration and higher immediate stone free rate with less complication

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Author Biographies

Rajan Koju, Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.

Lecturer,

Department of Surgery.

Hemnath Joshi, Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.

Associate Professor,

Department of Surgery.

Sujan Makaju Shrestha, Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.

Lecturer,

Department of Surgery.

Robin Karmacharya, Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.

Assistant Professor,

Department of Surgery.

Narendra Shalike, Dhulikhel Hospital, Kathmandu University Hospital, Dulikhel, Nepal.

Lecturer,

Department of Surgery.

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Published
2020-06-06
How to Cite
1.
Koju R, Joshi H, Shrestha S, Karmacharya R, Shalike N. A Comparative Study Between Pneumatic and Laser Lithotripsy for Proximal Ureteric Calculus. J Lumbini Med Coll [Internet]. 6Jun.2020 [cited 9Jul.2020];8(1):5 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/303
Section
Original Research Article