Research Article

Perbandingan efektivitas teknik modifikasi dan konvensional pada operasi open pyelolithotomy batu staghorn

I Gede Hendra Sucipta , Anak Agung Gde Oka, I Gede Raka Widiana

I Gede Hendra Sucipta
Residen Bedah Umum,Universitas Udayana-RSUP Sanglah. Email: gede.hendra.sucipta@gmail.com

Anak Agung Gde Oka
Bagian Urologi, Departemen Bedah, Fakultas Kedokteran Universitas Udayana-RSUP Sanglah, Bali-Indonesia

I Gede Raka Widiana
Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Online First: April 01, 2019 | Cite this Article
Sucipta, I., Oka, A., Widiana, I. 2019. Perbandingan efektivitas teknik modifikasi dan konvensional pada operasi open pyelolithotomy batu staghorn. Intisari Sains Medis 10(1). DOI:10.15562/ism.v10i1.318


Background: Open pyelolithotomy for staghorn stone patient management has a high stone-free rate. The disadvantages of open pyelolithotomy include aesthetics and postoperative complications, so a breakthrough to reduce these complications is needed, which can be achieved by doing modified open pyelolithotomy.

Objective: To compare the modified and conventional open pyelolithotomy techniques according to the duration of operation, the volume of surgical bleeding, pain, and post-operative drop in hemoglobin (Hb).

Method: A quasi-experimental study with twenty-two samples of staghorn stone patients was collected from October 2016 to October 2017. Parametric tests were used as data were normally distributed and homogeneous. The independent t-test was used to compare each measured parameter according to the type of operation. Analysis of covariance (ANCOVA) was used to control the variables of age, gender, and body mass index (BMI).

Result: The modified technique had a shorter operating duration than the conventional method (p < .05). The volume of surgical bleeding in the modified technique was lower compared to the conventional technique (p < .05). Pain scores in the modified technique were lower than the conventional technique (p <  .05). The drop in Hb levels in the modified technique was lower than the conventional technique (p < .05). Analysis using ANCOVA found that the type of operation has a direct effect on the duration of operation, volume of surgical bleeding, and post-operative pain.

Conclusion: The modified open pyelolithotomy technique was more effective than the conventional open pyelolithotomy technique based on the duration of operation, the volume of surgical bleeding, and post-operative pain scale. In this study, it was found that the drop in Hb levels was not directly affected by the type of surgery.

References

Ferri FF. Urolithiasis in Clinical Advisor Instant Diagnosis and Treatment, Rhode Island. Department of Community Health Brown Medical School Providence. 2004. 893-95

Husseiny TE, Buchholz N. The role of open stone surgery. Arab J Urol. 2012 Sep; 10(3): 284–288. DOI: 10.1016/j.aju.2012.03.004

Woodhouse CR, Farrell CR, Paris AM, Blandy JP. The place of extended pyelolithotomy (Gil-Vernet Operation) in the management of renal staghorn calculi. Br J Urol. 1981 Dec;53(6):520-3. DOI: 10.1111/j.1464-410x.1981.tb03252.x

Khalaf I, Salih E, El-Mallah E, Farghal S, Abdul-Raouf A. The outcome of open renal stone surgery calls for limitation of its use: A single institution experience. African Journal of Urology. 2013;19:58-65. DOI: 10.1016/j.afju.2013.04.001

Haggag YM, Morsy G, Badr MM, Al Emam AB, Farid M, Etafy M. Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones. Can Urol Assoc J. 2013 Mar-Apr;7(3-4):E171-5. DOI; 10.5489/cuaj.490

Swearingen R, Sood A, Madi R, Klaassen Z, Badani K, Elder JS et al. Zero-fragment Nephrolithotomy: A Multi-center Evaluation of Robotic Pyelolithotomy and Nephrolithotomy for Treating Renal Stones. European Urology. 2017 Dec;72(6):1014-1021. DOI: 10.1016/j.eururo.2016.10.021.

Sofia HN, Manickavasakam K, Walter TM. Prevalence and Risk Factors of Kidney Stone. Global Journal for Research Analysis. 2016;5(3):2277-8160.

Lee JK, Kim BS, Park YK. Predictive Factors for Bleeding During Percutaneous Nephrolithotomy. Korean J Urol. 2013 Jul; 54(7): 448-453. DOI: 10.4111/kju.2013.54.7.448

Romero V, Akpinar H, Assimos DG. Kidney Stones: A Global Picture of Prevalence, Incidence and Associated Risk Factors. Rev Urol. 2010 Spring-Summer; 12(2-3): e86-e96. DOI: 10.3909/riu0459

Celik H, Karazindiyanoglu S, Gokcen K, Kobaner M. One Year Experience of Urological Surgery with 99 cases in a State Hospital. J Turgut Ozal Med Cent. 2015; 22: 235-8

Patloo AM, Sarmast AH, Khan MA, Khan MA, Zaz M, Khan MA et al. Laparoscopic retroperitoneal pyelolithotomy and open pyelolithotomy: a comparative study. Turkish Journal of Urology. 2012; 38(4): 195-200. DOI: 10.5152/tud.2012.041

Altin S., Topaktas R., Akkoc A., Aydm C., Girgin R., Aydin Z.B., Yildirim K. 2016. Our Initial Experience with Laparoscopic Urologic Surgery, no. 43, pp.43-49

Singal R, Dhar S. Retroperitoneal laparascopic pyelolithotomy in renal pelvic stone versus open surgery-a comparative study. Clujul Med. 2018; 91(1): 85-91. DOI: 10.15386/cjmed-732.

Zehri AA, Biyabani SR, Siddiqui KM, Memon A. Triggers of blood transfusion in percutaneous nephrolithotomy. J Coll Physicians Surg Pak. 2011 Mar; 21(3): 138-41. DOI: 03.2011/JCPSP.138141


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