A Randomised Prospective Analysis of Effectivness of ESWL vs PCNL in Renal Stone Size 1-2 cm and Review of Literature

ABSTRACT

Introduction: Majority of renal stones diagnosed todayare below 2 cm. The preferred treatment of <1cm stone isextracorporeal shockwave lithotripsy (ESWL) while standardof care for renal stone >2 cm is percutaneous nephrolithotomy (PCNL). The procedure of choice for 1-2 cm renalstones is still a subject of debate. This study was undertakento formulate a better understanding of management of renalstones of size 1-2cm in this patient populationMaterial and methods: A prospective study was carried outto evaluate clearance of ESWL vs PCNL in patients with renalstones of size 1-2 cm. Complete follow up data were availablefor 281 patients 140 in PCNL and 141 in ESWL group, 12patients were lost to follow up.Results: Both the groups were well matched with regards toage and sex distribution. 141 patients underwent ESWL and103/141(73%) patients had stone clearance in 1-3 months. 140patients underwent PCNL out of which 133 (95%) patientshad stone clearance. Complications were mostly minor andfound in 9.7% in patients undergoing ESWL while same wereseen in 30% of those undergoing PCNL.Conclusion: The primary objective in stone management istotal stone clearance. Considering this as priority PCNL hasproved superior to ESWL in our study for renal stones 1-2 cmin size. It has also got lower auxiliary and retreatment rates buthas its own share of complications and longer hospital stay areother important factors in PCNL.