COMPARISON OF CONVENTIONAL NEPHROLITHOTOMY WITH PERCUTANEOUS NEPHROLITHOTOMY

Effect on Renal Function as Clinically Determined after Surgery

Abstract

The influence of renal surgery on postoperative renal function was studied by excretory urography (infusion method), biochemical measurement and urinalysis.
Eighty-eight patients were divided into 2 groups: the CNL group (44 Kidneys from 44 patients) underwent conventional nephrolithotomy: the PNL group (46 kidneys from the other 44 patients) underwent percutaneous nephrolithotomy.
The variables obtained from infusion urogram were the time required for ureteral visualization, the number of calyces, the area covered by the nephrogram and the thickness of the parenchyma at the incision or punction into the calyces. Biochemical measurements included BUN and serum creatinine concentration. In postoperative urinalysis, durations of hematuria and pyuria were determined.
Time required for ureteral visualization was longer in the CNL group at any given postoperation time. The nephrogram area decreased by 10.6% in the CNL group and by 3.5% in the PNL group. The number of calyces decreased by 66.7% in the CNL group and by 9.9%in the PNL group. Parenchymal thickness at the kidney incision decreased 20% in the CNL group and only 2.6% in the PNL group.
Postoperative elevation of serum creatinine concentration was observed in both groups, but the elevation in the CNL group remained more marked and was of longer duration than that in the PNL group.
The average duration of hematuria was 33.3±20.1days (mean±SD) in the CNL group and 26.3±12.5 days (mean±SD) in the PNL group.
The average duration of pyuria was 36.9±20.4 days (mean±SD) in the CNL group, 20.9±15.2 days (mean±SD) in the PNL group.
The present results demonstrate that percutaneous nephrolithotomy causes less renal dysfunction than conventional nephrolithotomy.