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Br Med J (Clin Res Ed). 1986 March 29; 292(6524): 879–882.
PMCID: PMC1339981

Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.


This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL. Comparative total costs to the NHS were estimated as 3500 pounds for open surgery, 1861 pounds for percutaneous nephrolithotomy, 1789 pounds for ESWL, and 3210 pounds for both ESWL and nephrolithotomy. ESWL caused no blood loss and little morbidity and is the cheapest and quickest way of returning patients to normal life.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Payne SR, Ford TF, Wickham JE. Endoscopic management of upper urinary tract stones. Br J Surg. 1985 Oct;72(10):822–824. [PubMed]
  • Wickham JE, Coe N, Ward JP. One hundred cases of nephrolithotomy under hypothermia. J Urol. 1974 Dec;112(6):702–705. [PubMed]

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