Comparison of Percutaneous Nephrolithotomy with Retrograde Intrarenal Surgery Techniques in treatment of renal lower calyceal stones

Muhammed Suhaib Almufti
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Abstract

Background and objectives: The aim of this study is a random prospective comparison in the outcomes of patients treated with percutaneous nephrolithotomy and retrograde intrarenal surgery in management of renal stones regarding stone free rate, quality of life, complications, fluoroscopy use, analgesic requirements and duration of hospital stay. Methods: This study was conducted in Hawler / Paky hospital Urology department between January 2019 and June 2019 in a prospective study. A total of 50 patients ages between 18-65 years with renal lower calyceal stone; single or multiple and size between 1-2 cm were randomized into two groups of 25 patients; patients treated with percutaneous nephrolithotomy (n; 25) and patients treated with retrograde intrarenal surgery techniques (n; 25). Results: : There was no statistical significant difference between the 2 groups in regard to patients’ pre-operative stone size, stone skin distance, complete blood count, creatinine values, analgesia requirement and stone-free rates. There were significantly higher values in regard to hospital stay, amount of radiation, percentage of hematocrit decrease due to bleeding and complication status in percutaneous nephrolithotomy compared to retrograde intrarenal surgery. Preoperative stone sizes for patients with percutaneous nephrolithotomy and retrograde intrarenal surgery was 15.7 ± 2.5 mm, 13.6 ± 2.2 mm, respectively, statistically there was no significant difference. Conclusions: We deduced that both percutaneous nephrolithotomy and retrograde intrarenal surgery minimal invasive surgical techniques can be applied to treat renal lower calyceal stones. Both techniques do not differ in stone-free rate, but in case of complications, fluoroscopy use, bleeding and hospital stay were higher in percutaneous nephrolithotomy.
经皮肾镜取石术与逆行肾内手术治疗肾下盏结石的比较
背景和目的:本研究的目的是对经皮肾镜取石术和逆行肾内手术治疗肾结石的患者进行随机前瞻性比较,包括结石清除率、生活质量、并发症、透视使用、镇痛需求和住院时间。方法:本研究于2019年1月至2019年6月在Hawler / Paky医院泌尿外科进行前瞻性研究。共50例年龄在18-65岁之间的肾下盏结石患者;单个或多个且大小在1-2 cm之间的患者随机分为两组25例;经皮肾镜取石术(n;25例)和采用逆行肾内手术技术治疗的患者(n;25)。结果:两组患者术前结石大小、结石皮距、全血细胞计数、肌酐值、镇痛需求、结石清除率比较,差异均无统计学意义。经皮肾镜取石术在住院时间、放射线量、出血所致红细胞压积下降百分比和并发症情况方面均明显高于逆行肾内手术。经皮肾镜取石术与逆行肾内手术患者术前结石大小分别为15.7±2.5 mm、13.6±2.2 mm,差异无统计学意义。结论:我们认为经皮肾镜取石术和逆行肾内手术均可用于治疗肾下盏结石。两种技术在结石清除率上没有差异,但在并发症的情况下,经皮肾镜取石术的使用、出血和住院时间更高。
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