Retrograde Intra-Renal Surgery Versus Percutaneous Nephrolithotomy in Management of Renal Stone 10-20 Millimeters, A Comparative Clinical Study
Keywords:Retrograde Intra-renal Surgery, Percutaneous Nephrolithotomy, treatment of renal stones.
Purpose: comparison the efficacy and safety of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in treatment of renal stones. Patients and Methods: Records of patients who underwent
surgery for renal stone were retrospectively reviewed, for two years from the beginning of 2017 till the end
of 2019. Patients who had renal stones between 10 - 20 Millimeter and located in different renal calices
were included, patients who underwent percutaneous nephron-lithotomy PNL and retrograde intra-renal
surgery RIRS were defined as Group I and Group II, respectively. Patient criteria (age, sex, BMI); the stone
characteristics; time of procedure, fluoroscopy and hospitalization; stone-free and complications (bleeding,
pain, infection, visceral injury, conversion to open surgery, and need for blood transfusion) were evaluated
between the treatment groups. Result: There were no significant differences in terms of age, gender, BMI,
laterality, number of stones, Hounsfield units and surface area characteristics of the stone between the PNL
(n 25) and RIRS (n = 35) groups (P = .558, P = .278, P = .375, P = 0.051, P = .053, P = .064, P = .642, P =
.080, respectively). Stone free rate was 59.6% (n=28) in PNL, and 88.6% (n=31) in RIRS (P=.004). 1st or
2nd degree complications according to Modified Clavien Classification developed in 10 patients (21.3%) in
Group I and 1 patient (2.9%) in Group II (P = .015). The 3A or 3B complications were similar in groups (P
= .077). Time of procedure, fluoroscopy and hospitalization were significantly lower in Group II (P < .001,
P < .001 and P < .001, respectively). Conclusion: RIRS is more effective and more reliable procedure than
PNL with higher stone-free and lower complication rates in treatment of single renal stone (10 t0 20 mm).
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