Comparison of stone-free rate between percutaneous nephrolithotomy and retrograde intrarenal surgery

Abstract

Background: The management of urolithiasis in the kidney has been drastically changed in the era of endourology, mainly consisting of three surgical procedures: extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS). Since ESWL is usually less invasive via ambulatory clinic routes, this study aimed to examine the stone-free rate (SFR) between PCNL and RIRS. Methods: We retrospectively reviewed patients who had renal stones and were treated with either PCNL or RIRS from June 2016 to June 2018. Staghorn stones, stones with diameters <1 cm, and stones with diameters >2 cm were excluded. Patients who underwent multiple surgeries for bilateral renal stones and those with graft kidney stones were excluded from the study. X-ray, sonography, and/or computed tomography (CT) were used to calculate the size of the stones. Follow-up was evaluated by the same image examination within three months after surgery. Stone-free was defined as no residual stone or the presence of asymptomatic calculi <4 mm. The operation time was defined as a skin-to-skin interval. Results: Following exclusion criteria, there were 39 patients in each arm, with no difference in age, sex, or any other demographic data. The average stone size in the PCNL and RIRS groups was 16.3 and 14.0 mm, respectively (p = 0.009). There was no significant difference in SFR (71.8% vs 61.5%, p = 0.337); the operation time was significant longer (p < 0.001), and the hospital stay was significantly shorter (p < 0.001) in the RIRS group. Conclusion: PCNL and RIRS are both feasible options for managing kidney stones. However, the initial stone size might affect the selection of operation. The SFR in the PCNL group was numerically but not statistically higher. The RIRS group, on the other hand, had a longer operation time but a shorter hospital stays.

Early oral diet may enhance recovery from benign gynecologic surgery: A single center prospective study

“…4,5,33 Second, minimally invasive surgery is a part of the ERAS protocol. [34][35][36][37][38][39][40] Our multivariate regression analysis results also validated the positive impact of laparoscopic surgery on the length of hospital stay.…”

“…Finally, we found that some independent factors, such as laparoscopic surgery and lower VAS scores, were related to reduced hospital stay. Minimally invasive surgery, 2,8 including robotic surgery, 9,10 natural orifice surgery, 35,36,38 and laparoscopic surgery, 12,35,37–39 has become increasingly popular in recent decades, although some controversial issues remain. 41 Additionally, adequate pain control is the milestone for successful surgical treatment and should always be applied.…”

Initial experience of percutaneous nephrolithotomy surgery in secondary hospital in Bali

“…There were 2.5 % cases with bleeding and 7.5 % cases with perforation as its intraoperative complication. Study by Atmoko et al [22] had 62.6 % from 345 patients and study by Chen et al [23] had 71.8 % from 39 patients.…”