Comparison of flexible ureterorenoscopy and mini-percutaneous nephrolithotomy in treatment of lower calyceal stones smaller than 2 cm

Abstract

To compare the outcomes of flexible ureterorenoscopy (F-URS) and mini-percutaneous nephrolithotomy (mini-PNL) in the treatment of lower calyceal stones smaller than 2 cm. Patients who underwent F-URS and mini-PNL for the treatment of lower calyceal stones smaller than 2 cm between March 2009 and December 2014 were retrospectively evaluated. Ninety-four patients were divided into two groups by treatment modality: F-URS (Group 1: 63 patients) and mini-PNL (Group 2: 31 patients). All patients were preoperatively diagnosed with intravenous pyelography or computed tomography. Success rates for F-URS and mini-PNL at postoperative first month were 85.7% and 90.3%, respectively. Operation time, fluoroscopy time, and hospitalization time for F-URS and mini-PNL patients were 44.40 min, 2.9 min, 22.4 h, and 91.9 min, 6.4 min, and 63.8 h, respectively. All three parameters were significantly shorter among the F-URS group (p < 0.001). Postoperative hemoglobin drop was significantly lower in F-URS group compared to mini-PNL group (0.39 mg/dL vs. 1.15 mg/dL, p = 0.001). A comparison of complications according to the Clavien classification demonstrated significant differences between the groups (p = 0.001). More patients in the F-URS groups require antibiotics due to urinary tract infection, and more patients in the mini-PNL group required ureteral double J catheter insertion under general anesthesia. Although both F-URS and mini-PNL have similar success rates for the treatment of lower calyceal stones, F-URS appears to be more favorable due to shorter fluoroscopy and hospitalization times; and lower hemoglobin drops. Multicenter and studies using higher patient volumes are needed to confirm these findings.

Is Retrograde Intrarenal Surgery Prefereable Over Mini Percutaneous Nephrolithotomy in Patients With Renal Calculus of Less Than or Equal to 2 Cm Size?

“…Stone free rate in our study was 90.9% in RIRS group as compared with 93.9% in miniPCNL group which was statistically not signicant (p = 0.642). Our results were comparable with study by Fatih Akbulut et al and found to [14] have similar result with 85.7% stone clearance rate in RIRS group and 90.3% in miniPCNL group which was not signicant statistically (p 0.53). Similar results were observed from studies conducted by Sabnis et al , Kirac M et al and Altaf [15] [16] Khan et al with no signicant difference in stone free rate in [17] both groups.…”

“…21 showed signicantly less hospital stay in RIRS (2.0±1.0 days and 1.9±1.3 days) group compared to miniPCNL (3.5±1.3 days and 4.4±1.4 days) group. Study done by Fatih Akbulut et al also showed results with less hospital stay in RIRS [14] group (22.4±18.2 hours) as compared with miniPCNL group (63.8±32.1 hours) which was statistically signicant (p<0.001).However, study done by Sabnis et al showed no [15] statistical difference in duration of post-operative stay between RIRS and miniPCNL group (p= 0.24)…”

Treatment of Lower Pole Renal Stones. Extracorporeal Shockwave Lithotripsy Versus Intrarenal and Percutaneous Surgery

“…El tiempo medio para una sesión de LEOC está entre 42.3 ± 6.3 y 48.3 ± 16 (17,19). El tiempo de intervención medio para la CIR varía con el tamaño de la litiasis: con litiasis mayores de 2 cm es de 117.5 ± 28.7 min y con litiasis menores de 2 cm es de 60.8 ± 19.9 min (17,19,(21)(22)(23)(24). Con respecto a la NLP el tiempo medio de intervención es de 73.7 ± 31.3 min y el de la miniperc de 72.1 ± 30.4 min (18,23).…”

The impact of metabolic syndrome on the safety and efficacy of flexible ureterorenoscopy

“…The impact of metabolic syndrome on the safety and efficacy of flexible ureterorenoscopy nephrolithotomy (PCNL) (4)(5)(6). However, to date, few studies have been available to confirm the safety and efficacy of fURS in patients with metabolic syndrome.…”