Tubeless mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for lower calyceal stones of ⩽2 cm: A
Amr S Fayad1, Mohamed G Elsheikh1, Waleed Ghoneima1
1Department of Urology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Objective:
To assess the safety, efficacy, and stone-free rate (SFR) of mini-percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) for the management of lower calyceal stones of ⩽2 cm, and to determine the advantages and disadvantages of each.
Patients And Methods:
In all, 120 patients with lower calyceal stones of ⩽2 cm were randomly divided into two equal groups: Group A were managed by mini-PCNL and Group B by RIRS using flexible ureteroscopy and laser. The mean age, sex, stone size, operating time, complications, hospital stay, and SFR were compared between the groups. The success of the procedure was defined as the absence of residual stones or small residuals of ⩽0.2 cm on computed tomography at 12 weeks postoperatively.
Results:
Both groups were comparable for preoperative parameters. The mean (SD) operating time was statistically significantly longer in Group B [109.66 (20.75) min] as compared to Group A [71.66 (10.36) min]. Although the hospital stay was longer in Group A as compared to Group B this was not statistically significant (P = 0.244). The SFR for Group A was 92.72% and for Group B it was 84.31%, which was not significantly different (P = 0.060).
Conclusion:
For treating lower calyceal stones of ⩽2 cm mini-PCNL and RIRS are comparable. Mini-PCNL had a better SFR than RIRS but the hospital stay was longer and there were more intraoperative complications, whilst, RIRS had a significantly longer operating time compared with mini-PCNL and a higher incidence of postoperative fever, and a lower SFR.
