Gaudji B.G, Moshokoa E.M, Bornman M.S, Becker P. Department of ...
Gaudji B.G, Moshokoa E.M, Bornman M.S, Becker P. Department of ...
Gaudji B.G, Moshokoa E.M, Bornman M.S, Becker P. Department of ...
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<strong>Gaudji</strong> B.G, <strong>Moshokoa</strong> E.M, <strong>Bornman</strong> M.S, <strong>Becker</strong> P.<br />
<strong>Department</strong> <strong>of</strong> Urology<br />
University <strong>of</strong> Pretoria<br />
South Africa
Percutaneous nephrolithotomy (PCNL) is<br />
regarded as the most challenging and<br />
morbid <strong>of</strong> minimally invasive surgery for<br />
kidney stone removal¹.<br />
Increasing prevalence <strong>of</strong> upper urinary tract<br />
stone diseases in South Africa, especially at<br />
SBAH, due to lifestyle changes across<br />
different racial groups².<br />
report on :<br />
Nature and variety <strong>of</strong> stone burden;<br />
Operating time, Morbidity, stone clearance;<br />
Retreatment;<br />
Cost.
Retrospective study based on 106 patients<br />
PCNL and URS with laser for upper urinary<br />
calculi between 2008 and 2012<br />
PCNL and URS disposable kits<br />
Holmium Laser(sphinx)³<br />
Disease characteristics, intra-operative and<br />
post-operative data were reported<br />
Estimated cost was for hiring flexible URS with<br />
laser and consumables.
Pre-OP Post-OP<br />
P21<br />
Average Stone burden = 2cm –8cm
Pre-OP Post-OP
Pre-OP<br />
Post-OP
P36<br />
Pre-OP Post-OP
Pre-OP Post-OP<br />
P71
Pre-OP P79 Post-OP
Gender 14 females<br />
42 males<br />
PCNL URS<br />
19 females<br />
31 males<br />
Operating Time 166.30 ± 50,40 min 110 ± 22.9min p
PCNL :<br />
Longer operating time and higher morbidity<br />
Higher stone clearance<br />
Lower cost<br />
URS with Laser:<br />
Lower morbidity and shorter hospital stay<br />
Lower stone clearance with higher retreatment rate<br />
Higher cost including disposable equipment<br />
At this point <strong>of</strong> time, PCNL seems more effective in terms <strong>of</strong><br />
stone clearance and cost.<br />
These findings will assist to setup a stone center and to<br />
implement effective management and policy for endo-<br />
urological procedures, based on adequate risks assessment for<br />
surgical outcome� .<br />
5
Dr Cilliers . D<br />
Dr Van Heerden .I<br />
Dr Engelbrecht .T