Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm

Abstract

Purpose To compare the efficacy of RIRS and PNL in lower pole stones ≥2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients’ preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups.Results There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups.Conclusions RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.

Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

“…17 Despite its slight invasiveness, of all the treatment options, PCNL delivers the stone free rate more than 90% for lower pole stones >20mm. [18][19][20][21] In the present study, the overall stone free rate for PCNL in six weeks was 92.6% for stone size less than 20mm and 90.7% for stone size >20mm which was comparable to the stone free rate in the series by Netto et al and Cass AS. 22,23 The study also showed that the stone free rate in relation to stone size was not statistically significant ( P value o.78).…”

Thermobalancing Therapy® should be the First-Line Treatment for Kidney Stones and Benign Prostatic Hyperplasia, Discussions at the Medical Conferences

“…Some authors came to conclusion that RIRS can be alternative to PCNL in selected cases [18]. RIRS can be an effective treatment alternative to PNL [19,20]. As RIRS affords a comparable success rate to PNL and causes fewer risks of complications it seems to be a promising alternative to PNL when larger stones are to be treated [21,22].…”

Innovations in surgical stone disease

“…There have been a number of mainly retrospective studies comparing RIRS and PCNL for the management of large renal stones [4][5][6][7][8][9][10][11][12][13][14][15]. De et al [16 && ] performed a systematic review and meta-analysis comparing RIRS and PCNL for the management of renal stones that included two randomized and eight nonrandomized studies.…”