Mini-percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Renal Stones Larger Than 10 mm: A Prospective Randomized Controlled Trial - 19/11/15
, Hyeon Jeong b, ⁎ Abstract |
Objective |
To compare miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) in the management of renal stones >10 mm in a single session.
Methods |
Seventy patients presenting with renal stones >10 mm were randomized to a mini-PCNL or an RIRS group in a ratio of 1:1. Randomization was performed by a biostatistician and opened to the surgeon at the time of the patient's admission on the day before surgery. Patient and stone characteristics, perioperative outcomes, and complications were compared between the 2 groups. The primary end point of “stone-free” which was defined as no residual stone or stones <2 mm on computed tomography within 3 months postoperatively.
Results |
Thirty-five patients (mini-PCNL) and 33 (RIRS) were included in the final analysis. Mini-PCNL and RIRS had a stone-free rate of 85.7% and 97.0%, respectively (P = .199). Operation time (P = .148), hemoglobin decline (P = .323), and hospital stay (P = .728) were similar between the 2 groups. Pain visual analog score at 1 hour postoperatively (P = .029) and analgesic requirement (P = .050) were higher in the RIRS group. Two patients in the mini-PCNL group and 1 in the RIRS group had minor pelvic or ureter perforation. One patient in each of the 2 groups had hypertension and urinary tract infection.
Conclusion |
Mini-PCNL and RIRS are safe and feasible surgical options to manage renal stones >10 mm. RIRS produced a slightly higher stone-free rate, but more immediate postoperative pain and higher analgesic requirement compared with mini-PCNL.
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| Sung Yong Cho and Hyeon Jeong contributed equally to this article. |
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| Financial Disclosure: The authors declare that they have no relevant financial interests. |
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| Funding Support: This study was supported by grant number 16-2013-11 from the SK Telecom Research Fund. |
Vol 86 - N° 5
P. 873-877 - novembre 2015 Retour au numéro
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