A Comparative Study Between Anterior and Posterior Pyelotomy in Transperitoneal Laparoscopic Pyelolithotomy

Damascus University

Status: Completed

Conditions: Large Renal Stone

Treatments: Procedure: modified transperitoneal laparoscopic pyelolithotomy; Procedure: traditional transperitoneal laparoscopic pyelolithotomy

Study type: Interventional

Funder types: Other

Identifiers

NCT06394219

Posterior Pyelotomy

Details and patient eligibility

About

Large renal pelvic stones are frequently managed with percutaneous nephrolithotomy (PCNL) but laparoscopic pyelolithotomy (LPL) can be an alternative procedure when performed by skilled surgeons to achieve excellent outcomes in terms of stone free status, operative time, postoperative kidney function, hospitalization duration, and complications.

there are two methods for LPL surgery : Transperitoneal (TLP) and Retroperitoneal (RLP).

RLP associated with shorter mean time for oral intake, and mean hospital stay after surgery.

The surgical exposure in the transperitoneal route for LP is familiar to the majority of surgeons. Also, a much larger working space is available and there are various established anatomical landmarks for performing the surgery effectively. This study introduces a modified technique that creates application of posterior pyelotomy in TLP to achieve the advantages of RLP

Full description

This is a randomized controlled clinical trial that aims to collect a sample within two years from the date of approval of the Scientific Research Council at Damascus University.

The study will focus on a group of patients who will undergo a transperitoneal laparoscopic pyelolithotomy surgery.

The patients will be randomly divided into two groups. The first group will undergo a traditional transperitoneal laparoscopic pyelolithotomy, which involves application of anterior pyelotomy.

The second group will receive a modified transperitoneal laparoscopic pyelolithotomy, which involves application of posterior pyelotomy.

The data will be compared between the two groups in terms of the mean duration of surgery ,mean time for oral intake ,and mean hospital stay

Enrollment: 36 patients

Sex: All

Ages: 15 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with large renal pelvic stone > 2 cm .
• failure of minimally invasive approaches such as PCNL or ESWL
• stones that were neither amenable to ESWL nor were ideally suitable for PCNL
• Patient's preference for a quick one-stage procedure.
• Negative urine culture

Exclusion criteria

• Patients refusing study participation.
• Contraindication to general anesthesia.
• Contraindication to laparoscopic surgery.
• Patients with an intrarenal pelvis.
• Previous surgical on the same kidney.
• Associated anatomical deformity.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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36 participants in 2 patient groups

Anterior Pyelotomy

Experimental group

Description:

Traditional transperitoneal laparoscopic pyelolithotomy: Patients who were randomized to receive classic transperitoneal laparoscopic pyelolithotomy

Treatment:

Procedure: traditional transperitoneal laparoscopic pyelolithotomy

Posterior Pyelotomy

Experimental group

Description:

Modified transperitoneal laparoscopic pyelolithotomy: Patients who were randomized to receive modified transperitoneal laparoscopic pyelolithotomy by applying posterior pyelotomy.

Treatment:

Procedure: modified transperitoneal laparoscopic pyelolithotomy