A Randomized Controlled Study to Analyze the Safety and Efficacy of Percutaneous Nephrolithotripsy and Retrograde Intrarenal Surgery in the Management of Renal Stones More Than 2 cm in Diameter

Bryniarski, Piotr; Paradysz, Andrzej; Życzkowski, Marcin; Kupilas, Andrzej; Nowakowski, Krzysztof; Bogacki, Rafał

doi:10.1089/end.2011.0235

Cited by 133 publications

(110 citation statements)

References 18 publications

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“…A relatively acceptable SFR was achieved with the help of f-URS in our study. Using s-URS in the management of renal pelvic stones may offer some advantages such as shorter operation and hospitalization times when compared to f-URS and PCNL [9,10]. In our study, mean operation times was shorter in the s-URS group.…”

Section: Discussionmentioning

confidence: 46%

“…However, research on the use of s-URS to treat renal stones were limited, and s-URS is not accepted as a primary treatment modality. Success rates of s-URS at reaching renal pelvis were reported to be between 53-91% in some studies [9,10,28]. SFR and complications that were encountered in those series were presented in table-3.…”

Section: Discussionmentioning

confidence: 96%

“…It has been suggested that use of s-URS for the extraction of main stone mass may lead to lower procedural costs by decreasing the need for f-URS and protecting relatively fragile flexible instruments [7]. In addition, it is reported that s-URS is obviously more cost-effective than RIRS and PCNL, especially when the amount of painkillers used, hospital stay and operative times were taken into consideration [10]. It is also noted that cost of repair was two times higher for flexible ureteroscopes when compared with s-URS and using s-URS will minimize the repair costs of instruments [6].…”

Section: Discussionmentioning

confidence: 99%

“…To date, some studies are reporting the use of rigid or s-URS in the treatment of renal pelvic stones in the literature [9,10]. However, studies comparing the outcomes of s-URS with PCNL and f-URS were limited.…”

mentioning

confidence: 99%

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Comparison of ureteroscopy and percutaneous nephrolithotomy for renal pelvic stones over 2 cm

Küçükdurmaz¹

2018

Ann Clin Anal Med

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Aim: Advances in the technology of ureteroscopes and lithotriptors have led to the implementation of retrograde intrarenal surgery (RIRS) in the treatment of renal Stones. This study aimed to compare the outcomes and complications of semirigid ureterorenoscopy (s-URS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal pelvic stones larger than 2 cm, retrospectively. Material and Method: Between January 2014 and July 2016, 90 patients with single renal pelvic stones of more than 2 cm were treated by PCNL (group 1) or s-URS (group 2). Group 1 had 44; group 2 had 46 patients. Demographic features of patients such as age, gender, body mass index (BMI) as well as stone size were compared. Perioperative course and postoperative outcomes such as stone-free and complication rates were also evaluated. Patients assessed by plain abdominal radiography 24 hours after surgery and non-contrast computed tomography at 3rd months, postoperatively. Clinical success was defined as stone-free status. Results: Mean ages of patients in group 1 and 2 were 40.29±19.78 and 38.41±23.26 year, respectively (p=0.681). Two groups were comparable in terms of gender, BMI, grade of hydronephrosis. Mean stone sizes were also similar. The mean operation, fluoroscopy and hospitalization times were shorter in group 2. After first sessions, mean stone-free rates for PCNL and s-URS were 81.8% and 60.8%, respectively (p=0.037). In the s-URS group,11 patients underwent f-URS due to stone migration into lower calix, and 7 of them became stone-free after those procedures. At 3rd months follow-up, those rates were determined as 84.1% and 76%, respectively. Discussion: Although s-URS is not superior to PCNL in the treatment of large renal pelvic stones, it can be used to reach renal pelvis and fragment those stones in selected cases.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of ureteroscopy and percutaneous nephrolithotomy for renal pelvic stones over 2 cm

Küçükdurmaz¹

2018

Ann Clin Anal Med

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“…In a recent randomised study in patients with renal stones >2 cm, S-URS, although less efficacious, was found to be advantageous over PCNL in terms of operating time, drop of haemoglobin and haematocrit, postoperative visual analogue score, need for analgesia and duration of hospital stay [10]. In order to minimise total flexible URS time, Ebert and Schafhauser used the semirigid ureteroscope for laser lithotripsy in 12 patients with resistant renal calculi, after repositioning of the stones in the renal pelvis with the flexible instrument [11].…”

Section: Discussionmentioning

confidence: 96%

Semirigid Laser Ureterolithotripsy for Single Large Renal Pelvic Stones

Mitsogiannis¹,

Papatsoris²,

Varkarakis³

et al. 2013

Med Surg Urol

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Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Srisubat

Potisat

Lojanapiwat

et al. 2014

Cochrane Database of Systematic Reviews

192

115

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Results from five small studies, with low methodological quality, indicated ESWL is less effective for kidney stones than PCNL but not significantly different from RIRS. Hospital stay and duration of treatment was less with ESWL. Larger RCTs with high methodological quality are required to investigate the effectiveness and complications of ESWL for kidney stones compared to PCNL if there is any technological progress in the non-invasive elimination of the residual fragments. Moreover, further research is required for the outcomes of ESWL and RIRS in lower and non-lower pole studies including PCNL versus RIRS.

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A Randomized Controlled Study to Analyze the Safety and Efficacy of Percutaneous Nephrolithotripsy and Retrograde Intrarenal Surgery in the Management of Renal Stones More Than 2 cm in Diameter

Abstract: The efficacy of RIRS is acceptable and, emphasizing its high safety, it should be considered as a valuable alternative option for management of renal pelvic stones more than 2 cm in diameter.

Cited by 133 publications

References 18 publications

Comparison of ureteroscopy and percutaneous nephrolithotomy for renal pelvic stones over 2 cm

Comparison of ureteroscopy and percutaneous nephrolithotomy for renal pelvic stones over 2 cm

Semirigid Laser Ureterolithotripsy for Single Large Renal Pelvic Stones

Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

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