A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience

Bozzini, Giorgio; Verze, Paolo; Arcaniolo, Davide; Piaz, O. Dal; Buffi, Nicolò Maria; Guazzoni, Giorgio; Provenzano, Marco; Osmolorskij, Boris; Sanguedolce, Francesco; Montanari, Emanuele; Macchione, Nicola; Pummer, Karl; Mirone, Vincenzo; Sio, Marco De; Taverna, Gianluigi

doi:10.1007/s00345-017-2084-7

Cited by 91 publications

(91 citation statements)

References 34 publications

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“…It is very well discussed in literature as a systematic review and meta-analysis showed PCNL and RIRS were superior to ESWL in stone clearance and even PCNL is more effective then RIRS(9). In 2017 Bozzini et al performed a prospective randomized comparison among ESWL, PCNL and RIRS on <2cm sized LC stones (10). ESWL was failed against PCNL and RIRS considering SFR and re-treatment rates(p<0.05).…”

Section: Discussionmentioning

confidence: 99%

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.

Bozzini

Aydoğan

Müller³

et al. 2020

Preprint

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Background Conventional Percutaneous Lithotripsy (PCNL) has been an effective, successful and easy approach for especially >1 cm sized calyceal stones however risks of complications and nephron loss are inevitable. Our aim is to compare the efficacy and safety of PCNL, MiniPerc(MP) and UltraMiniPerc(UMP) for lower calyceal stones between 1 and 2 cm with a multicenter prospective randomized study.Methods Between January 2015 and June 2018, 132 consecutive patients with single lower calyceal stone were enrolled. Patients were randomized in three groups; A: PCNL; B: MP; C: UMP. 44 patients for the Group A, 47 for Group B and 41 for Group C. Exclusion criterias were the presence of coagulation impairments, age of <18 or >75, presence of infection or serious comorbidities. Patients were controlled with computerized tomography scan after 3 months. A negative CT or an asymptomatic patient with stone fragments < 3 mm size were the criteria to assess the stone-free status. Patient characteristics, stone free rates (SFR)s, complications and re-treatment rates were analyzed.Results The mean stone size were 16.38, 17.82 and 15.23mm respectively in Group A, B and C(p=0.34). The overall SFR was significantly higher in Group A (86.3%) and B (82.9%) as compared to Group C (78%)(p<0.05). The re-treatment rate was significantly higher in Group C (12.1%) and complication rates was higher in Group A (13.6%) as compared to others(p<0.05). The hospitalization was significantly shorter in Group C compared to Group A(p=0.04).Conclusions PCNL and MP showed higher efficacy than UMP to obtain a better SFR. Auxiliary and re-treatment rates were higher in UMP. On the other hand for such this kind of stones PCNL had more complications. Overall evaluation favors MP as a better indication in stones 1-2 cm size.

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Section: Discussionmentioning

confidence: 99%

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.

Bozzini

Aydoğan

Müller³

et al. 2020

Preprint

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“…Some surgeons believed that either RIRS or PCNL surgery is needed even if the diameter of LPSs is less than 1.0 cm [18]. Endourology surgery is widely used to treat calculi with diameter less than 2.0 cm [19]. The application of RIRS or UMP in the treatment of calculi larger than 2 cm in diameter is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5–3.5 cm)

Lai

Shah

et al. 2020

BMC Urol

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Background: To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n = 33) or modified UMP (n = 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p < 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p < 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p < 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p < 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p < 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p = 0.504, p = 0.675). There were no significant differences between the two groups in complications (p = 0.228). Conclusion: For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

Li¹,

Lai

Shah

et al. 2020

Preprint

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Background：To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion：For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience

Cited by 91 publications

References 34 publications

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.

Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5–3.5 cm)

Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

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