Intelligent pressure-controlled retrograde intrarenal surgery versus microchannel percutaneous nephrolithotomy to treat 2-3 cm renal calculi.

Abstract

We performed a comparative analysis of intelligent pressure-controlled ureteroscopic lithotripsy (IRIRS) and intelligent pressure-controlled microchannel percutaneous nephrolithotomy (IMPCNL) to treat 2-3 cm renal calculi. Patients (n = 140) with 2-3 cm renal calculi were randomly divided into the IRIRS and IMPCNL groups (n = 70/group). Surgical time, length of hospital stays, stone clearance rate, decrease in hemoglobin level, postoperative pain score, and incidence of complications were compared between groups. The IRIRS group had significantly longer operative durations than the IMPCNL group (average: 58.3 ± 7.4 vs. 52.5 ± 6.8 min). Stone clearance rates at 4 weeks postoperatively were 90.0% and 92.8% in the IRIRS and IMPCNL groups, respectively (P > 0.05). The IRIRS group had shorter hospital stays than the IMPCNL group (1.9 ± 0.3 vs. 3.2 ± 0.4 days). Intraoperative hemoglobin levels decreased more in the IMPCNL (1.03 ± 0.12 g/dL) than in the IRIRS (0.25 ± 0.06 g/dL, P < 0.001) group. Two and one cases in the IRIRS and IMPCNL group, respectively, experienced postoperative fever. The overall complication incidence did not significantly differ (12.9% IRIRS and 15.7% IMPCNL; P > 0.05). IRIRS and IMPCNL are safe, effective interventions for 2-3 cm renal calculi. Given its minimally invasive nature and positive operative safety outcomes, IRIRS has promising future applications.