ROLE OF OPEN RENAL STONE SURGERY IN ERA OF MINIMAL INVASIVE SURGERY
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Keywords
Invasive Surgery, Open Surgery, Renal Stone, Complications
Abstract
OBJECTIVE: To compare the outcomes of laparoscopic versus open surgical techniques among renal stone patients.
METHODOLOGY: This descriptive cross-sectional study was done at the Sindh Institute of Urology & Transplantation (SIUT) in Karachi, Pakistan, for a duration of six months, from April to September 2024. A cohort of 246 individuals, aged 18 to 60, of either gender, diagnosed with renal stone (single or multiple) > 10 mm planned to be removed surgically were assessed. Patients were admitted a day before surgery and given intravenous Tazocin 4.5gm every 8 hourly for urinary sterility. Laparoscopic or open surgery including urethral catheter before was based on the type of stone, and CT KUB for a urologist. Operative details and postoperative length of hospitalization, stone clearance rates, and complications were recorded. The Clavien-Dindo classification system was used to categorize the complications and stone-free status was defined as a complete absence of any residual stones on abdominal CT-scan 4 weeks after the procedure. Statistical data was analyzed using SPSS version 26.
RESULTS: The mean age was 62.56 ± 10.36 years for subjects in the open surgery group and 61.74 ± 10.45 years for those in laparoscopy group (p=0.537). Among 246 patients, 61.8% in the open group and 65.0% in the laparoscopy groups were male. Laparoscopy had significantly shorter operation times (237.20vs.265.65 minutes, P=0.002) and much lower blood loss (179.39vs.410.24 mL, P=0.0001). However, open surgery showed higher stone clearance rates (89.4%vs.75.6%, P=0.004).
CONCLUSION: This study underscores that open renal stone surgery still has a firm place in urology. Since minimally invasive techniques offer advantages such as shorter operative times and less blood loss. For a complete stone removal open surgery is still more effective than any other method. The insignificant difference was noted in complication rate. Based on these results, it is recommended that more research is undertaken on larger populations of patients to validate the current findings.
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Dr. Bilal Memon
Postgraduate Trainee, MBBS, Sindh Institute of Urology and Transplantation (SIUT), Karachi
Prof. Murli Lal
Professor, MBBS, MS, Sindh Institute of Urology and Transplantation (SIUT), Karachi
Dr. Kalhoro Gm
Assistant Professor, MBBS, FCPS, Sindh Institute of Urology and Transplantation (SIUT), Karachi
Dr. Naveed Ahmed Mahar
Associate Professor, MBBS, FCPS, Sindh Institute of Urology and Transplantation (SIUT), Karachi
Dr. Adil Hussain
Postgraduate Trainee, MBBS, Sindh Institute of Urology and Transplantation (SIUT), Karachi
Sajid Atif Aleem
Lecturer, MSc, MPhil, Jinnah Sindh Medical University