Percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones up to 2 cm in patients with solitary kidney: a single centre experience

Abstract

BackgroundTo compare the treatment outcomes between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the management of stones larger than 2 cm in patients with solitary kidney.MethodsOne hundred sixteen patients with a solitary kidney who underwent RIRS (n = 56) or PCNL (n = 60) for large renal stones (>2 cm) between Jan 2010 and Nov 2015 have been considered. The patients’ characteristics, stone characteristics, operative time, incidence of complications, hospital stay, and stone-free rates (SFR) have been evaluated.ResultsSFRs after one session were 19.6% and 35.7% for RIRS and PCNL respectively (p = 0.047), but the SFR at 3 months follow-up comparable in both groups (82.1% vs. 88.3%, p = 0.346). The calculated mean operative time for RIRS was longer (p < 0.001), but the mean postoperatively hospital stay was statistically significantly shorter (p < 0.001) and average drop in hemoglobin level was less (p = 0.040). PCNL showed a higher complication rate, although this difference was not statistically significant.ConclusionsSatisfactory stone clearance can be achieved with multi-session RIRS in the treatment of renal stones larger than 2 cm in patients with solitary kidney. RIRS can be considered as an alternative to PCNL in selected cases.

Forecast and Guiding role of using Hounsfield unit in retrograde intrarenal surgery for the treatment of renal stone of 2-3 cm: A single center prospective study

“…Our results con rmed that PCNL offered a higher SFR than RIRS as well, which was consistent with most published studies [8,20,2]. Zewu et al supposed that the potential reasons for RIRS with a relatively lower SFR may be due to residual fragments that are more likely to represent a cluster of clinically insigni cant fragments and small working channel according literatures [25], as well as a call for the vacuum aspiration stone system for RIRS.…”

“…Percutaneous nephrolithotomy (PCNL) has been increasingly utilized in the treatment of large stone disease (>2 cm) nearing to 80 percent success rates. The technological advancements have remarkable decreased the role of open surgery considerably in the treatment of kidney stones [2].…”

Renal function changes after percutaneous nephrolithotomy in patients with renal calculi with a solitary kidney compared to bilateral kidneys

“…Multiple punctures, supracostal access and a longer surgical duration may be needed for complex stones, but these risk factors significantly increase the complication rates of bleeding, fever, and renal function impairment . Other studies reported initial and final SFRs of 35.7–52.1% and 71.7–88.3%, respectively, after PCNL in patients with a SK , which means a balance between higher SFRs and lower complication rates can be attained in large experienced centres. Our lower initial SFR may be attributed to a high stone burden and the high proportion of patients with complex renal calculi.…”

Percutaneous nephrolithotomy vs. retrograde intrarenal surgery for renal stones larger than 2cm in patients with a solitary kidney: A systematic review and a meta-analysis

“…Numerous studies comparing PCNL and RIRS for large kidney stones in solitary kidney patients have been reported recently [12][13][14][15]. However, no evaluation outcomes comparing PCNL with RIRS have been published yet.…”