Comparative study of retrograde intrarenal surgery and micropercutaneous nephrolithotomy in the treatment of intermediate-sized kidney stones

Fata, F. Ramón de; García-Tello, A.; Andrés, Germán; Redondo, C.; Meilán, E.; Gimbernat, H.; Angulo, Javier

doi:10.1016/j.acuroe.2014.09.007

Cited by 21 publications

(10 citation statements)

References 29 publications

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“…Başlangıçta küçük böbrek taşlarına mikro-PNL önerilirken, son zamanlarda orta büyüklükteki taşlarada mikro-PNL yapılabileceği gösterilmiştir (6,7). Mikro-PNL, ESWL ve Retrograd intrarenal cerrahi (RIRC)'ye alternatif olarak sunulmuştur (6,8). ESWL nin küçük ve orta büyüklükteki taşlarda başarı oranı %40-%90 arasında bildirilmiştir (9)(10)(11).…”

Section: Discussionunclassified

Our initial experiences in Micro Percutaneous Nephrolithotomy

Taken¹,

Eryılmaz²,

Ergün³

et al. 2016

Van Med J

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GirişBöbrek taşı tedavisinde gelişen komplikasyon oranlarını azaltmak için klasik perkütan nefrolitotomi (PNL) prosederünü takiben akses traktı daha küçük olan mini ve ultra-mini-PNL yöntemleri geliştirilmiştir (1,2).Mikro-PNL ise daha az invaziv, tek basamakta akses yapılan ve akses traktı daha küçük olan bir işlemdir (3,4). Mikro-PNL'nin en önemli avantajı kanamanın az olması ve komşu organ yaralanması riskinin az olmasıdır (5,6). Mikroperkütan nefrolitotomi, küçük ve orta büyüklükteki seçilmiş olgulara önerilmektedir (7). Sonuç:Mikroperkütan nefrolitotomi, düşük-orta büyüklükteki böbrek taşlarının tedavisinde güvenli ve etkin bir tedavi yöntemidir. Anahtar Kelimeler: Böbrek taşı, tedavi, mikro-perkütan nefrolitotomi ABSTRACTObjective: We aimed to evaluate our initial micropercutaneous nephrolithotomy (micro-PNL) experiences. Materaials and Methods:In this study the results of 10 patients who underwent micro-PNL for renal stones between August 2014 and January 2015 in Yüzüncü Yıl University were evaluated. All interventions were performed in the prone position under general anesthesia. In all patients 4.85 F all-seeing needle was used. The stones were fragmented using [8 Hz (6.4 W) 0.8 J] 200 lm or 270 lm Ho: YAG laser fiber under direct visualization. The procedure was terminated with no need of any nephrostomy tube. Stone-free rates 1 day and 1 month postoperatively were assessed by US, and KUB. The patients were evaluated by CT when thought residue stone. Results:The mean age of patients in this study was 26.7 ± 20.6 (3-43) years, and the mean stone size was 13.1 ± 5.15 (0.9-22) mm and the mean operation duration was 38 (24-58) min. The mean hospital stay was 1.76 ± 0.65 (1-5) days, and the mean drop in the hemoglobin level was 0.82 ± 0.84 (0-1.3) mg/dL. None of our patients required transfusion. Ureteral J stent was implanted in 4 (40%) patients. One (10 %) patient complained of postoperative renal colic and abdominal distension was observed in one patients (10 %) who was 3 years old. They were treated conservatively. Also postoperative fever was seen in only one patient. In one patient residue stone was detected by CT. Conclusions:Micro-PNL is a safe and effective treatment method for small and moderately sized kidney stones.

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Section: Discussionunclassified

Our initial experiences in Micro Percutaneous Nephrolithotomy

Taken¹,

Eryılmaz²,

Ergün³

et al. 2016

Van Med J

View full text Add to dashboard Cite

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“…All studies included were full-text articles. Among all the studies, RIRS was compared with mini-PCNL in six studies [14][15][16][17][18][19], micro-PCNL in three studies [20][21][22], ultra-mini PCNL in two studies [23,24], and mixture of mini and micro PCNL in one study [25]. Agreement between the two reviewers was 91.67% for quality assessment of articles.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Nine of nonrandomized articles [14,15,[17][18][19][20][21]23,24] (NOS: 6 or more of 9 points) were thought to be of high quality, the rest one [25] was low (NOS: 3 of 9 points) (Supplementary Table S2), and two RCTs were also high quality (Supplementary Table S3). None of the included trails discussed about allocation concealment.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…All studies excluded Kiremit's [25] take age, gender, and stone sizes into considerations, and there is no signification difference between each group. During our research, there were only two small sampled RCTs [16,22] (level of evidence: 2b); eight retrospective studies [14,15,17,19,20,[23][24][25] discussed contemporary series of patients (LE: 3b); three were two prospective studies [18,21], and one of them was matchedpair study [18] (LE: 2b), and the rest [21] was prospective data collection (LE: 3b). As for surgical indications, six studies were about mini-PCNL, three studies about micro-PCNL, two about ultra-mini PCNL, and one study discuss mini-PCNL and micro-PCNL at the same time.…”

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

“…Matching criteria in trails were variable expect for one study [25], which had no declarations. Ten studies [14][15][16][17][18][19][20][21][22]24] talked about the detail length of followup. Methods for handling missing data were declared in the majority, but not for intention-to-treat.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Li¹,

Zheng²,

Zang³

et al. 2018

biomedicalresearch

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Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) are widely used in the management of kidney stones. But the safety and efficiency between these two technologies is still a mystery. This meta-analysis was performed to compare the efficacy as well as safety of Minimally Invasive Percutaneous Procedures (MIPPs) including ultra mini-PCNL, mini-PCNL, and micro-PCNL with RIRS. PubMed, Embase and Scopus were searched, and twelve studies included data on 1207 cases (613 for MIPPs and 594 for RIRS) satisfied the inclusion criteria and were included in this research finally. MIPPs were found to be associated with higher stone-free rate but longer hospital stays, and a larger drop in hemoglobin levels. Difference between MIPPs and RIRS in complication rate, operative time, and total cost were not notable. Given no obvious difference in the complication rate and higher efficacy, our findings suggest that mini-PCNL should be recommended over RIRS for stones>2 cm, and that for stones<2 cm any of MIPPs or RIRS are reasonable.

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Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures

et al. 2015

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The objective of this study was to audit the costs of retrograde intrarenal surgery (RIRS) and micropercutaneous nephrolithotomy (microperc) and compare them in terms of cost-effectiveness. We performed a retrospective analysis of 63 patients who underwent microperc and 48 patients who underwent RIRS. The cases, performed between first use and first repair, were used for this initial study. The costs associated with performing RIRS and microperc, including the costs of devices, disposables, hospitalization, and additional required treatments, were audited. The main perioperative and postoperative parameters were collected, including operation time, JJ stent requirements, used disposables, stone-free rates, and complications. Statistical analyses of the means of continuous variables were performed using Student's t test and the Mann-Whitney U test. Categorical variables were analyzed using Chi-squared tests. The mean cost of RIRS was $917.13 ± 73.62 and the mean cost of microperc was $831.58 ± 79.51; this difference was statistically significant (p < 0.001). The mean operation time of the RIRS group was significantly shorter than the microperc group (55.62 ± 19.62 min and 98.50 ± 29.64 min, respectively, p < 0.001). The assessment of required additional treatment showed that it was significantly higher in the RIRS group than the microperc group (p = 0.02). The stone-free rate for RIRS was 66.6 and 80.9 % for microperc; this difference was not statistically significant (p = 0.12). In our series, the use of microperc is less expensive than RIRS due to additional required treatments and ancillary equipment in RIRS. RIRS is more effective than microperc in terms of operation time and more effective use of operation rooms.

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Comparative study of retrograde intrarenal surgery and micropercutaneous nephrolithotomy in the treatment of intermediate-sized kidney stones

Cited by 21 publications

References 29 publications

Our initial experiences in Micro Percutaneous Nephrolithotomy

Our initial experiences in Micro Percutaneous Nephrolithotomy

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures

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