A Randomised Prospective Analysis of Effectivness of ESWL vs PCNL in Renal Stone Size 1-2 cm and Review of Literature
International Journal of Contemporary Medical Research [IJCMR]
Majority of renal stones diagnosed today are below 2 cm. The preferred treatment of <1cm stone is extracorporeal shockwave lithotripsy (ESWL) while standard of care for renal stone >2 cm is percutaneous nephrolithotomy (PCNL). The procedure of choice for 1-2 cm renal stones is still a subject of debate. This study was undertaken to formulate a better understanding of management of renal stones of size 1-2cm in this patient population Material and methods: A prospective study was carried out to
... was carried out to evaluate clearance of ESWL vs PCNL in patients with renal stones of size 1-2 cm. Complete follow up data were available for 281 patients 140 in PCNL and 141 in ESWL group, 12 patients were lost to follow up. Results: Both the groups were well matched with regards to age and sex distribution. 141 patients underwent ESWL and 103/141(73%) patients had stone clearance in 1-3 months. 140 patients underwent PCNL out of which 133 (95%) patients had stone clearance. Complications were mostly minor and found in 9.7% in patients undergoing ESWL while same were seen in 30% of those undergoing PCNL. Conclusion: The primary objective in stone management is total stone clearance. Considering this as priority PCNL has proved superior to ESWL in our study for renal stones 1-2 cm in size. It has also got lower auxiliary and retreatment rates but has its own share of complications and longer hospital stay are other important factors in PCNL.