Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Öztürk, Ufuk; Şener, Nevzat Can; Göktuğ, Hasan Nedim Göksel; Nalbant, İsmail; Gücük, Adnan; İmamoğlu, Abdurrahim

doi:10.1159/000351136

Cited by 66 publications

(41 citation statements)

References 20 publications

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“…The SFR data in our study is very consistent with the result of previous studies by Ozturk et al [17] and Kumar et al [18]. Furthermore, we observed that the re-treatment rate for SWL was higher than that of UMP and FURS (p < 0.05).…”

Section: Discussionsupporting

confidence: 93%

“…The efficacy of SWL is influenced by the size of the stone, the composition of the stone, the lower calyceal angle and the patient's body habitus, which may reduce the effect of SWL and increase the rate of retreatment [4]. The other milestone as far as minimally invasive interventions for treatment of renal stones is PCNL [5]. Even though PCNL is the first-line therapy with the highest success rate, its relatively higher invasiveness and complication rates have prompted a search for alternative therapies.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Efficacy of Ultra-Mini PCNL, Flexible Ureteroscopy, and Shock Wave Lithotripsy on the Treatment of 1–2 cm Lower Pole Renal Calculi

Zhang

Tian

et al. 2018

Urol Int

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Objective: To compare the efficacy of new percutaneous technique (“ultra-mini PCNL”, UMP), shock wave lithotripsy (SWL) and flexible ureteroscopy (FURS) on the treatment of 1–2 cm lower pole kidney stones, and to determine the advantages and disadvantages of each method. Materials and Methods: This prospective study was based on data collected from the files of patients between March 2015 and March 2017. This study recruited a total of 180 patients with single radio-opaque lower caliceal calculi of 1–2 cm. All patients were randomly divided into 3 groups: group A was treated with UMP, group B was treated with FURS by using holmium laser and group C was treated with SWL by using the electromagnetic lithotripter. The average age, sex, size of the stone, the time of operation, the rate of no stone, the time of hospitalization, the rate of retreatment, the cost and the complications of the 3 groups were compared. The success of the operation was defined as no residual stone or < 0.3 cm on computed tomography at 3 months postoperatively. Results: The stone burdens of the groups were equivalent. The re-treatment rate in group C was significantly higher than that in group A and B (30 vs. 1.6%, 5%). The average operating time in group B (93.35 ± 21.64 min) was statistically significantly longer than that in group A and C (68.58 ± 15.82 min, 46.33 ± 5.81 min). Although the time of hospitalization of group A (5.32 ± 1.20 day) was longer than that of group B (3.22 ± 0.52 day) and C (1.08 ± 0.28 day; p < 0.05). The stone-free rate (SFR) in UMP, FURS, SWL were 98, 92, and 73% respectively; the highest SFR was in the UMP group (p < 0.05). The complication rates were evaluated by using the Clavien grading system, which were determined to be 16.67% in UMP, 6.67% in SWL and 8.33% in FURS. In particular, the complications of GI and GII were more common in group A (p < 0.05). Conclusions: UMP, FURS, and SWL are all safe and effective in the treatment of 1–2 cm lower pole kidney stones. UMP and FURS had a better SFR than SWL, but the time of hospitalization in UMP group was longer and there were more complications in the UMP group. In addition, the operation time of FURS is longer as compared to UMP and SWL, and there is a higher rate of postoperative fever. The invasiveness and cost of SWL were lower than that of UMP and FURS, but the re-treatment rate was higher.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of Ultra-Mini PCNL, Flexible Ureteroscopy, and Shock Wave Lithotripsy on the Treatment of 1–2 cm Lower Pole Renal Calculi

Zhang

Tian

et al. 2018

Urol Int

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“…The reasons for exclusion: renal stones >2 cm (n = 8), renal stones 1-3 cm (n = 1), and kidney stones 10 mm or less (n = 1). Finally, seven studies [5][6][7][8][9][10][11] were included in the meta-analysis, three RCT [5][6][7] and four CCT [8][9][10][11], published between 2012 and 2014. The literature screening process has been shown in Fig.…”

Section: Study Descriptionmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

et al. 2015

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This study is to evaluate the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) versus retrograde intrarenal surgery (RIRS) for the treatment for renal calculi 1-2 cm. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Database were researched and hand-searched for relevant congress abstracts and journals about RIRS and ESWL for the treatment for 1- to 2-cm renal stones. The retrieval time ended in September 2014. The related trials met the inclusion criteria were included in the meta-analysis. Two reviewers independently assessed the quality of all included studies, and meta-analysis was performed with RevMan 5.2. Seven literatures were retrieved, including 983 patients. The meta-analysis results showed that, compared to RIRS group, the patients in ESWL group had the following features:(1) the stone-free rate [relative risk (RR) 0.86; 95% confidence interval (CI) 0.77-0.95, P = 0.005] was significantly different between two groups; (2) The retreatment rate of RIRS group was lower (RR 8.12; 95% CI 4.77-13.83, P < 0.00); (3) The complications were not significantly different between two groups (Grade I RR 1.06; 95% CI 0.67-1.69, P = 0.80; Grade II RR 0.75; 95% CI 0.29-1.91, P = 0.54; Grade III RR 0.86; 95% CI 0.26-2.86, P = 0.80). Compared to ESWL, our results showed that RIRS provided significantly higher stone-free rate and lower retreatment rate and without increase in the incidence of complications. However, further randomized trials are needed to confirm these findings.

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“…[6][7][8] In the AUA guideline, this rate has been given as 78 percent. [4] In our study, in 74 patients, a 70.3% stone-free rate has been detected.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

Aydemi̇r

Budak

Kumsar

et al. 2014

Turkish Journal of Urology

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Objective: In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Material and methods:Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. Results:The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm 2 in the PNL, 1.4±0.1 cm 2 in the RIRS, and 3.1±0.9 cm 2 in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups.Conclusion: PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

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Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Cited by 66 publications

References 20 publications

Comparison of the Efficacy of Ultra-Mini PCNL, Flexible Ureteroscopy, and Shock Wave Lithotripsy on the Treatment of 1–2 cm Lower Pole Renal Calculi

Comparison of the Efficacy of Ultra-Mini PCNL, Flexible Ureteroscopy, and Shock Wave Lithotripsy on the Treatment of 1–2 cm Lower Pole Renal Calculi

Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones

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