Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of renal stones greater than 2 cm

Abstract

Objective: To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones greater than 2 cm and to compare its results with those of percutaneous nephrolithotomy (PCNL). Material and methods:We retrospectively analyzed a total of 143 patients: 86 patients (53 males and 33 females) who underwent PCNL and 57 patients (37 males and 20 females) who underwent RIRS between October 2009 and October 2013. Results:The mean duration of operation was 100.26±33.26 min in the RIRS group and 75.55±21.5 min in the PCNL group (p<0.001). The hospital stay was significantly shorter in the RIRS group (1.56±0.8 vs. 4.57±2.1 days in the RIRS and PCNL groups, respectively; p<0.001). Stone-free rates after one session were 66.6% and 91.8% of the RIRS and PCNL groups, respectively. The stone-free rate of the RIRS group improved to 87.7% after the second session. Blood transfusions were required in two patients in the PCNL group. Complication rates were higher in the PCNL group. Conclusion:This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stones with a diameter of 2-4 cm especially in patients with comorbidities.

Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2 cm

“…In Galbraith radial plot, 2 studies, including those of Pan et al and Karakoc et al, [ 17 , 22 ] produced heterogeneity; these 2 studies were excluded and subgroup analysis was performed. All of the remaining 9 studies were located within the funnel plot (Fig.…”

“…The authors considered comorbidities in patients with stones larger than 2 cm and concluded that RIRS is recommended for stones larger than 2 cm. [ 22 ] Palmero et al performed a retrospective analysis of 142 patients with renal stones (106 underwent RIRS and 36 underwent PCNL). Their PCNL group also exhibited a higher success rate than the RIRS group (80.6% vs 73.6%, respectively), although the difference in rates between groups was not statistically significant ( P = .40).…”

Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro

“…Os nossos resultados são consistentes com outros estudos. 6,[10][11][12][13] Já outros autores compararam a taxa de sucesso avaliada in loco pelo cirurgião com a taxa de sucesso avaliada através de imagem (com resultados concordantes de 97% e 99% de taxa de sucesso, respetivamente). 13 A significativa discrepân-cia que encontrámos no nosso estudo poderá ser explicada pela alta mobilidade do grande número de fragmentos classificados como residuais, que poderá ter dificultado a sua identificação.…”

“…É um estudo retrospetivo, não controlado, com todas as limitações inerentes a esta situação, nomeadamente na seleção de doentes; mas, por outro lado, incluiu um número superior de doentes comparativamente às séries publicadas sobre o tema. 12 Uma possível abordagem a fazer no futuro será medir também a carga litiásica pós-operatória pelo controlo imagiológico, de modo a calcular a taxa de redução da carga litiásica inicial, ao invés de analisar apenas a presença/ausência de litíase residual. A análise estatística poderá ser feita por doente (permitindo a análise detalhada das CIRR repetidas) e não por procedimento, que foi a abordagem utilizada no presente estudo.…”

Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stone

“…Today, the management of these kidney stones depends largely on percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS) and shock wave lithotripsy (SWL), with PCNL being considered the rst line treatment due to its high stone clearance rate [1]. Although, PCNL also accompanies higher complication rates [2].…”