Management of 1-2 cm renal stones

Srivastava, Aneesh; Chipde, Saurabh Sudhir

doi:10.4103/0970-1591.117280

Cited by 10 publications

(6 citation statements)

References 38 publications

(59 reference statements)

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“…PCNL plays a very important role in the treatment of nephrolithiasis, and was first applied in the late 1970s [7]. Due to the fact that it has lowered the incidence of complications, PCNL is now a primary and safe surgical option for treatment of urolithiasis [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

Wang¹,

Zhang²,

Xu³

et al. 2015

Urol Int

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Objective: To assess the safety and efficacy of ultrasonographic vs. fluoroscopic access for percutaneous nephrolithotomy (PCNL). Methods: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify clinically controlled trials (CCTs) and randomized controlled trials (RCTs) that compared ultrasonographic access with fluoroscopic access for PCNL. RevMan 5.1 software and Stat Manager V4.1 software were used for the meta-analysis. Results: Five RCTs and nine CCTs were included in our study, which contained a total of 3,019 patients. Of these, 1,574 (52%) had undergone ultrasonographic access, and 1,445 (48%) had undergone fluoroscopic access. The pooled results revealed that the ultrasonographic access patients had shorter duration of access (min) by 2.56 min (weighted mean difference (WMD) = −2.56, 95% confidence interval (CI): −4.40 to −0.72, p = 0.006). There was a higher stone-free rate in the ultrasonographic access group (odds ratio (OR) = 1.26, 95% CI: 1.02-1.55, p = 0.03), as well as a lower rate of operative complications (OR = 0.72, 95% CI: 0.56-0.93, p = 0.01), reduced intraoperative blood loss (ml) (WMD = −14.55 ml, 95% CI: −27.65 to −1.46, p = 0.03), and a lower rate of blood transfusion requirement (OR = 0.39, 95% CI: 0.24-0.63, p = 0.0001). Sensitivity and subgroup analyses were also performed. Conclusion: Except for no radiation exposure, our meta-analysis revealed that ultrasonographic access had many advantages, such as a shorter access time, reduced intraoperative blood loss, a lower rate of operative complications, a lower rate of blood transfusion, and a higher stone-free rate. Because of these significant advantages, we recommend the use of ultrasonographic access for PCNL.

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Section: Introductionmentioning

confidence: 99%

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

Wang¹,

Zhang²,

Xu³

et al. 2015

Urol Int

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“…15 It has been proved to be a less morbid procedure compared to open stone surgery and better stone clearance than ESWL. 16 The recent guidelines of European Association of Urology(EAU) also recommend PCNL for lower pole calyceal stones >1.5 cm. For smaller lower pole calyceal stones, ESWL is recommended if lithotripsy resistant hard stones such as brushite and cystine stones, long and narrow infundibulum, are absent.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

Dongol

Bohora

2018

J Nepal Health Res Council

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Background: Urolithiasis is a worldwide problem due to its high prevalence and recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones.Methods: Seventy patients who presented in between June 2013 and September 2017 with lower pole calyceal stones and lower calyceal stones with pelvic extension were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.

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“…Now that, ureteroscopy technology has advanced, calculi at almost all urinary tract locations can be accessed without restriction [3]. There are known indications for ureteroscopy, including unsuccessful SWL and incapacity to undergo SWL due to pregnancy, coagulopathy, or morbid obesity [4]. The stone clearance rate for renal stones <2 cm for RIRS is better than that for SWL as a primary procedure, and a good clearance rate is also achieved following the failure of SWL.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Treatment of Renal Stone Size Between 1.0 Cm and 2.5 Cm: A Comparative Study

Baheti

Trivedi

DOBARIA

et al. 2022

Asian J Pharm Clin Res

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Objectives: To evaluate the efficacy and safety of RIRS and PCNL in treatment of renal stone size between 1-2.5cm. Methods: This comparative prospective study was conducted in the Department of Urology of a tertiary care teaching hospital of Rajasthan from January 2019 to June 2020. Patients were fully informed about the study protocol and a written informed consent has obtained from patients with renal stone disease without any co-morbid conditions, posted for RIRS and PCNL. Stone free rate, post operative complications, hospital stay, operation time and cost between RIRS and PCNL for treatment of renal stone size between 1-2.5cm were compared. Results: Out of total 313 patients, 212 patients underwent PCNL and 101 patients RIRS. The stone clearance rate was significantly better in PCNL (92.45%) than RIRS (85.15%). The hospital stay was significantly less in RIRS (2.02±1.36 days) when compared to PCNL (3.89±2.18 days). Mean operative time for PCNL was significantly less i.e. 71.81±12.89 minutes as compared to 85.79±13.94 minutes in RIRS. Post-operative complications were more in PCNL group than RIRS. Conclusions: This study concluded that PCNL when compared to RIRS both have advantages and disadvantages according to size and location of stone, post-operative complications, stone free rate and operation cost. Judicious use of PCNL and RIRS should be done according to above mentioned parameters.

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Management of 1-2 cm renal stones

Cited by 10 publications

References 38 publications

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Treatment of Renal Stone Size Between 1.0 Cm and 2.5 Cm: A Comparative Study

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