Osman BARUT, Sefa RESİM, Faruk KÜÇÜKDURMAZ, Mehmet Kutlu DEMİRKOL, Bekir Türkay DEMİR, Tayfun ŞAHİNKANAT

Comparative Evaluation of MicropercutaneousNephrolithotomy and Retrograde Intrarenal Surgeryin the Management of Renal Stones 10–20mm in Size

Objective: To assess the effects of micropercutaneous nephrolithotomy (microperc) and retrograde intrarenal surgery (RIRS) on treating 10–20-mm kidney stones.Methods: Twenty-eight patients who underwent microperc (group 1) and 30 patients who underwent RIRS (group 2) between February 2015 and April 2017 were examined. This study included patients with 10–20-mm kidney stones located at a single location. Stone characteristics, fluoroscopy and operation times, stone-free rates (SFRs), and postoperative complications were compared between the two groups.Results: Age, gender, size, laterality, and stone location,and operation times were similar between the two groups. Moreover, the two groups had similar SFRs (92.9% vs. 90%, p=1.00, respectively). The mean fluoroscopy time was higher in group 1 than in group 2 (p=0.001). The two groups were similar in terms of SFRs (92.9% vs.90%, p=1.00, respectively). The decrease in hemoglobin levels was signifcantly more in group 1 than in group 2 (p=0.001).In terms of postoperative complications, no statistically significant difference was observed between the groups (p=0.277). The mean hospitalization time was 50.21±9.62 and 27.46±7.23 hours in groups 1 and 2, respectively (p=0.001).Conclusion: Both techniques are successful in treating renal stones and have low complication rates. Microperc is an effective method for managing medium-sized renal stones. However, longer fluoroscopy time and longer hospital stay are the main disadvantages of this technique.

PDF

___

1. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016; 69: 475-82. [Crossref]
2. Giusti G, Proietti S, Peschechera R, Taverna G, Sortino G, Cindolo L, et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World J Urol 2015; 33: 309-14. [Crossref]
3. Van Cleynenbreugel B, Kılıç Ö, Akand M. Retrograde intrarenal surgery for renal stones - Part 1. Turk J Urol 2017; 43: 112-21. [Crossref]
4. Ising S, Labenski H, Baltes S, Khaffaf A, Thomas C, Wiesner C. Flexible Ureterorenoscopy for Treatment of Kidney Stones: Establishment as Primary Standard Therapy in a Tertiary Stone Center. Urol Int 2015; 95: 329-35. [Crossref]
5. Javanmard B, Kashi AH, Mazloomfard MM, Ansari Jafari A, Arefanian S. Retrograde Intrarenal Surgery Versus Shock Wave Lithotripsy for Renal Stones Smaller Than 2 cm: A Randomized Clinical Trial. Urol J Oct 2016; 13: 2823-8.
6. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 1976; 10: 257-9. [Crossref]
7. de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, et al. The Clinical Research Office of the endourological society per-cutaneous nephrolithotomy global study: Indications, complications, and outcomes in 5803 patients. J Endourol 2011; 25: 11-7. [Crossref]
8. Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M. Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int 2011; 108: 896-9. [Crossref]
9. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol 2011; 186: 140-5. [Crossref]
10. Ganpule A, Chhabra JS, Kore V, Mishra S, Sabnis R, Desai M. Factors predicting outcomes of micropercutaneous nephrolithotomy: results from a large single-centre experience. BJU Int 2016; 117: 478- 83. [Crossref]
11. El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ. Flexible ureterorenoscopy versus extra corporeal shock wave lithotripsy for treatment of lower pole stones of 10-20 mm. BJU Int 2012; 110: 898-902. [Crossref]
12. Ansari MS, Gupta NP, Hemal AK, Dogra PN, Seth A, Aron M, et al. Spectrum of stone composition: Structural analysis of 1050 upper urinary tract calculi from northern India. Int J Urol 2005; 12: 12-6. [Crossref]
13. Donaldson JF, Lardas M, Scrimgeour D, Stewart F, MacLennan S, Lam TB, et al. Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery and percutaneous nephrolithotomy for lower-pole renal stones. Eur Urol 2015; 67: 612-6. [Crossref]
14. ChengF, Yu W, Zhang X, Yang S, Xia Y, Ruan Y. Minimally invasive tract in percutaneous nephrolithotomy for renal stones. J Endourol 2010; 24: 1579-82. [Crossref]
15. Pérez-Fentes D, Blanco-Gómez B, García-Freire C. Micropercutaneous nephrolithotomy. A new therapeutic option for pediatric renal lithiasis. Actas Urol Esp 2014; 38: 483-7. [Crossref]
16. Geraghty R, Abourmarzouk O, Rai B, Biyani CS, Rukin NJ, Somani BK. Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era. Curr Urol Rep 2015; 16: 54. [Crossref]
17. Sabnis RB, Jagtap J, Mishra S, Desai M. Treating renal calculi 1-2 cm in diameter with mini percutaneous or retrograde intrarenal surgery: A prospective comparative study. BJU Int 2012; 110: E 346-9. [Crossref]
18. Tepeler A, Armagan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol 2013; 27: 13-8. [Crossref]
19. Armagan A, Karatag T, Buldu I, Tosun M, Basibuyuk I, Istanbulluoglu MO, et al. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment form oderately size lower-pole stones. World J Urol 2015; 33: 1827-31. [Crossref]
20. Cepeda M, Amo’n JH, Mainez JA, De LCB, Rodrı’guez V, Alonso D, et al. Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 cm. Actas Urol Esp 2017; 41: 516-21. [Crossref]
21. Bagcioglu M, Demir A, Sulhan H, Karadag MA, Uslu M, Tekdogan UY. Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures. Urolithiasis 2016; 44: 339-44. [Crossref]
22. Kandemir A, Guven S, Balasar M, Sonmez MG, Taskapu H, Gurbuz R. A prospective randomized comparison of micropercutaneous nephrolithotomy (Microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones. World J Urol 2017; 35: 1771-6. [Crossref]
23. Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR. Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 2013; 112: 355-61. [Crossref]