COMPARISON OF OPEN URETERO-LITHOTOMY AND SEMI-RIGID URETEROSCOPY IN PAKISTAN’S PAEDRIATIC POPULATION WITH RESPECT TO MEAN OPERATIVE TIME, MEAN STONE FREE RATE, AND OTHER POSTOPERATIVE COMPLICATIONS. RETROSPECTIVE CROSS-SECTIONAL COMPARATIVE ANALYSIS

Ghulam Mujtaba Zafar; Muhammad Nadeem Sajjad; Fawad Humayun Akhtar; Fazal Ur Rehman Khan; Muhammad Zaheer; Hanan Yousuf

doi:10.46903/gjms/23.1.1784

COMPARISON OF OPEN URETERO-LITHOTOMY AND SEMI-RIGID URETEROSCOPY IN PAKISTAN’S PAEDRIATIC POPULATION WITH RESPECT TO MEAN OPERATIVE TIME, MEAN STONE FREE RATE, AND OTHER POSTOPERATIVE COMPLICATIONS. RETROSPECTIVE CROSS-SECTIONAL COMPARATIVE ANALYSIS

Ghulam Mujtaba Zafar, Muhammad Nadeem Sajjad, Fawad Humayun Akhtar, Fazal Ur Rehman Khan, Muhammad Zaheer, Hanan Yousuf

Abstract

Background: Pediatric urolithiasis is a significant health problem with considerable morbidity. In recent times, the treatment approach for these stones has evolved from traditional open surgical approaches to minimally invasive endourological techniques. The purpose of this study was to compare the results of open ureterolithotomy and semi-rigid ureteroscopy in the treatment of ureteric stones in the paediatric population in a tertiary care facility in Pakistan.

Materials & Methods: In this retrospective cross-sectional comparative study, 337 individuals with ureteric stone complaints who were under 15 years old and from a Pakistani tertiary care hospital were split into two groups at random and investigated retrospectively from June 2015 to December 2023. Two groups were created from all children under the age of 15 who had secondary hydronephro-ureter, ureteric stones, and failed MET. About 108 children in Group-B underwent open uretero-lithotomy, while 229 children in Group-A underwent semi-rigid ureteroscopy. We used the chi-squared test to compare the research groups. It was deemed statistically significant when the probability value was less than 0.05. A computer application called SPSS version 25.0 was used for all statistical calculations.

Result: The average age, stone size, and operating time for the 229 patients in Group-A were 7.01+2.530 years, 13.07+3.178 mm, and 45.31+6.712 minutes, respectively. Following one effort, the stone-free rate was 87.3%. Of these individuals, ureteral stricture only happened in 0.4% of cases, 0.9% had urinomas, and 7.0% had a fever. The mean stone size was 26.28+5.412 mm, the mean operative duration was 87.07+9.543 minutes, and the mean age of the 108 patients in Group-B was 10.06+3.627 years. Following one effort, the stone-free rate was 98.1%. Fever was reported by 1.9% of these patients, urinomas by 1.9%, and wound infections by 5.6%.

Conclusion: According to the study’s findings, for paediatric patients, semi-rigid ureteroscopy with lithotripsy is safer and more less invasive than open uretero-lithotomy.

Keywords

Semi-rigid ureteroscopy; uretero-lithotomy; ureteric stones; stone free rate; postoperative complications.

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DOI: https://doi.org/10.46903/gjms/23.1.1784