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28
TH
CONGRESS OF THE ESPU
10:23–10:26
S22-2 (PP)
★
ALL THAT GLITTERS IS NOT GOLD. CT KUB
AND INTRAVENOUS PYELOGRAM CAN BE SACRIFICED
IN A SAFE PERCUTANEOUS NEPHROLOITHOTOMY
Sherjeel SAULAT
1
, Adnan SIDDIQ
2
, Shariq ANEES
2
, Hammad MITHANI
2
and Salman EL KHALID
3
1) Kidney center post-graduate training institute, Paediatric Urology, Karachi, PAKISTAN - 2) The Kidney Center,
Urology, Karachi, PAKISTAN - 3) The kidney centre, Urology, Karachi, PAKISTAN
PURPOSE
The purpose of this study is and to compare the outcomes of the patients who underwent PCNL with
only a Xray KUB and a Ultrasound (Group A) with the group of patients who had an IVP or CT scan
done before the procedure (Group B) to review whether these traditional Gold standards are really
necessary or can they be omitted.
MATERIAL AND METHODS
we retrospectively reviewed the prospectively collected data of 142 children (149 renal units) who
underwent PCNL from November 2014 to April 2016.Patient’s data including age, gender, stone
burden, hemoglobin drop, operative time,radiation dose, complications and hospital stay duration
were documented. Successful outcome was a stone free renal unit on postoperative USG KUB.
Statistical analysis was done on SPSS 20 by using independent samplet-test and chi-square test.
RESULTS
149 PCNLs (Group A=101, Group B=48) were performed in 142 patients. The overall mean age
was 8.34+-4.8yrs. There was no significant difference regarding tract approach (p=0.75), tract punc-
ture site (p=0.55) and operative time (CI -17.68 -9.79, p=0.572). The stone burden in group A and
B was 2.91+-2.38cm2 vs 3.25+-2.44cm2 respectively with 95%CI -1.16-0.498 and an insignificant
p value (p=0.428).
The overall stone free rate of 149 renal units came out to be 94%. In group A the stone free rate
was 95% and in group B it was 92% and not statistically significant(p=0.823). One IVP or CT KUB
approximately costs about 50$ and therefore we saved about 5000$ of our healthcare budget of
our country
CONCLUSIONS
We conclude that PCNL has become the procedure of choice in last two decades for treatment of
renal stones due its safety and efficacy. As the expertise grows with PCNL, IVU and CT KUB can
easily be omitted in majority of patients to decrease the radiation exposure as well as the running
cost of the treatment.