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Miniperc and retrograde intrarenal surgery: when and how?

F Ramón de Fata1, K Hauner2, G Andrés1

  • 1Servicio de Urología, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, España.

Actas Urologicas Espanolas
|February 12, 2015
PubMed
Summary

Minimally invasive kidney stone treatments, mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS), show similar stone clearance and minimal complications. Further studies are needed to define their roles, but they are complementary urological options.

Keywords:
Cirugía Retrógrada intrarrenalIndicacionesIndicationsKidney stoneLitiasis RenalMini-Nefrolitotomía PercutáneaMinipercutaneous nephrolithotomyRetrograde intrarenal surgeryTechniqueTécnica

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Treatment

Background:

  • Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) are established kidney stone treatments.
  • ESWL has lower efficacy for lower calyx stones, while PCNL involves significant morbidity.
  • Innovations include miniaturized instruments and retrograde intrarenal surgery (RIRS).

Purpose of the Study:

  • To compare the efficacy and complications of mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) for kidney stone treatment.
  • To evaluate the current landscape of minimally invasive kidney stone procedures.

Main Methods:

  • A structured, nonsystematic literature review was performed.
  • Searched PubMed, Google Scholar, and Scopus databases for articles published between 1997 and 2013.
  • Keywords included: kidney stones, miniperc, mini-PCNL, RIRS, and flexible ureteroscopy.

Main Results:

  • Retrograde intrarenal surgery (RIRS) involves longer operative times, potential need for multiple procedures for large stones, and higher costs due to instrument fragility.
  • Mini percutaneous nephrolithotomy (mini-PCNL) is associated with longer hospital stays, increased need for postoperative pain management, and greater hemoglobin reduction, though transfusion rates are not elevated.
  • Both mini-PCNL and RIRS demonstrate equivalent stone clearance rates and minimal complications.

Conclusions:

  • Mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are current, minimally invasive options for kidney stone treatment.
  • These procedures are comparable in efficacy and complication rates.
  • Comparative prospective studies are essential to establish definitive roles; however, they are considered complementary techniques in urology.