Mini-percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Renal Stones Larger Than 10 mm: A Prospective Randomized Controlled Trial

Lee, Jeong W.oo; Park, Juhyun; Lee, Seung Bae; Son, Hwancheol; Cho, Sung Yong; Jeong, Hyeon

doi:10.1016/j.urology.2015.08.011

Cited by 73 publications

(60 citation statements)

References 12 publications

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“…Surgical technique for mini-PCNL differed in aspect of tract size and lithotripsy. As shown in Table 1, the studies consisted of three RCTs (LE: 2b) [11, 16, 22], two matched-pair analysis trails (LE: 3b) [13, 20], and eight case control studies (LE: 3b) including 4 prospective [14, 17, 21, 23] and 4 retrospective studies [12, 15, 18, 19]. In terms of the methodological quality, eight and two of the nonrandomized studies were relatively high (NOS: 7 of 9 points and 6 of 9 points) and medium (NOS: 5 of 9 points and 4 of 9 points), respectively.…”

Section: Resultsmentioning

confidence: 99%

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Jiang

Chen

et al. 2017

BioMed Research International

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Minimally invasive percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are both alternatives for PCNL to treat renal calculi. This study is aimed at comparing the stone-free rate (SFR) and other surgery parameters of two approaches for treating upper urinary calculi. We performed this meta-analysis in September 2016 by searching studies about mini-PCNL and RIRS for treating upper urinary calculi in various databases, and RevMan v.5.3 was applied. Three randomized controlled trials and ten nonrandomized trials were included, involving a total of 1317 patients. Meta-analysis showed that mini-PCNL group led to a higher SFR [odds ratio: 1.96; 95% confidence interval: 1.46–2.64; P < 0.00001] but brought a larger postoperative decrease in hemoglobin levels compared with RIRS. RIRS provided a shorter hospital time. There was no significant difference in operation time. Higher postoperative complications were detected in the mini-PCNL, but the difference was not significant. Grade I and III complications did not vary between two procedures, but grade II complications were of lower incidence in RIRS group. In the light of these results, compared with RIRS, mini-PCNL provided significantly higher SFR and efficiency quotient for managing calculi; however, it resulted in higher incidence of postoperative complications, larger hemoglobin drops, and longer hospital stay.

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Section: Resultsmentioning

confidence: 99%

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Jiang

Chen

et al. 2017

BioMed Research International

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“…Reports suggest that up to 12% of people will suffer from urinary tract calculi during their lifetime, and the rates of recurrence is close to 50% [1]. There are several treatment modalities for renal stones, including observation expecting spontaneous passage, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS) using flexible ureterorenoscope [2]. PCNL is currently the standard treatment for large renal stones considered too large for or refractory to shock wave lithotripsy [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials

et al. 2017

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BackgroundPercutaneous nephrolithotomy (PCNL) is performed to treat relatively large renal stones. Recent publications indicate that tubeless and total tubeless (stentless) PCNL is safe in selected patients. We performed a systematic review and network meta-analysis to evaluate the feasibility and safety of different PCNL procedures, including total tubeless, tubeless with stent, small-bore tube, and large-bore tube PCNLs.MethodsPubMed, Cochrane Central Register of Controlled Trials, and EMBASE™ databases were searched to identify randomized controlled trials published before December 30, 2013. One researcher examined all titles and abstracts found by the searches. Two investigators independently evaluated the full-text articles to determine whether those met the inclusion criteria. Qualities of included studies were rated with Cochrane’s risk-of-bias assessment tool.ResultsSixteen studies were included in the final syntheses including pairwise and network meta-analyses. Operation time, pain scores, and transfusion rates were not significantly different between PCNL procedures. Network meta-analyses demonstrated that for hemoglobin changes, total tubeless PCNL may be superior to standard PCNL (mean difference [MD] 0.65, 95% CI 0.14–1.13) and tubeless PCNLs with stent (MD -1.14, 95% CI -1.65–-0.62), and small-bore PCNL may be superior to tubeless PCNL with stent (MD 1.30, 95% CI 0.27–2.26). Network meta-analyses also showed that for length of hospital stay, total tubeless (MD 1.33, 95% CI 0.23–2.43) and tubeless PCNLs with stent (MD 0.99, 95% CI 0.19–1.79) may be superior to standard PCNL. In rank probability tests, small-bore tube and total tubeless PCNLs were superior for operation time, pain scores, and hemoglobin changes.ConclusionsFor hemoglobin changes, total tubeless and small-bore PCNLs may be superior to other methods. For hospital stay, total tubeless and tubeless PCNLs with stent may be superior to other procedures.

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“…All studies included were full-text articles. Among all the studies, RIRS was compared with mini-PCNL in six studies [14][15][16][17][18][19], micro-PCNL in three studies [20][21][22], ultra-mini PCNL in two studies [23,24], and mixture of mini and micro PCNL in one study [25]. Agreement between the two reviewers was 91.67% for quality assessment of articles.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…All studies excluded Kiremit's [25] take age, gender, and stone sizes into considerations, and there is no signification difference between each group. During our research, there were only two small sampled RCTs [16,22] (level of evidence: 2b); eight retrospective studies [14,15,17,19,20,[23][24][25] discussed contemporary series of patients (LE: 3b); three were two prospective studies [18,21], and one of them was matchedpair study [18] (LE: 2b), and the rest [21] was prospective data collection (LE: 3b). As for surgical indications, six studies were about mini-PCNL, three studies about micro-PCNL, two about ultra-mini PCNL, and one study discuss mini-PCNL and micro-PCNL at the same time.…”

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

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Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

Li¹,

Zheng²,

Zang³

et al. 2018

biomedicalresearch

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Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) are widely used in the management of kidney stones. But the safety and efficiency between these two technologies is still a mystery. This meta-analysis was performed to compare the efficacy as well as safety of Minimally Invasive Percutaneous Procedures (MIPPs) including ultra mini-PCNL, mini-PCNL, and micro-PCNL with RIRS. PubMed, Embase and Scopus were searched, and twelve studies included data on 1207 cases (613 for MIPPs and 594 for RIRS) satisfied the inclusion criteria and were included in this research finally. MIPPs were found to be associated with higher stone-free rate but longer hospital stays, and a larger drop in hemoglobin levels. Difference between MIPPs and RIRS in complication rate, operative time, and total cost were not notable. Given no obvious difference in the complication rate and higher efficacy, our findings suggest that mini-PCNL should be recommended over RIRS for stones>2 cm, and that for stones<2 cm any of MIPPs or RIRS are reasonable.

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Mini-percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Renal Stones Larger Than 10 mm: A Prospective Randomized Controlled Trial

Cited by 73 publications

References 12 publications

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials

Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis

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