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Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy results for 20-30 mm kidney stones: A matched-pair analysis

Year 2023, Volume: 15 Issue: 1, 9 - 15, 30.01.2023
https://doi.org/10.54233/endouroloji.1188796

Abstract

Objective: To compare the results of retrograde intrarenal surgery and percutaneous nephrolithotomy for 20-30 mm kidney stones.
Material and Methods: The demographic, radiologic, clinic and surgery related data of 324 patients who underwent retrograde intrarenal surgery and percutaneous nephrolithotomy for 20-30 mm kidney stones between January 2013 and July 2022 were retrospectively analyzed. All patients were divided into two roups as retrograde intrarenal surgery group and percutaneous nephrolithotomy group according to the surgery performed. After matching two groups in terms of age, number of stones, location of stones, stone size and stone density, 122 patients were included in the study (61 patients in retrograde intrarenal group and 61 patients in percutaneous nephrolithotomy group as 1:1).
Results: The success rate of retrograde intrarenal surgery group (78.7%) and percutaneous nephrolithotomy group (80.2%) were similar (p=0.823). There was no difference between two groups in terms of infective and non-infective complications (respectively, p=0.752 and p=0.61). There were statistically significant difference between the two groups in duration of operation and hospitalization. The median operation time was 70 (30-100) minutes and the median hospital stay was 1 (1-28) days in the RIRS group, while the median operation time was 90 (50-160) minutes and the median hospital stay was 4 (2-10) days in the PNL group (p<0.001).
Conclusion: Retrograde intrarenal surgery is a good alternative in the surgical treatment of 20-30 mm kidney stones with similar success and complication rates and also shorter operation time and hospitalization time.

References

  • 1. Tundo G, Vollstedt A, Meeks W, Pais V. Beyond Prevalence: Annual Cumulative Incidence of Kidney Stones in the United States. J Urol. 2021;205(6):1704-1709. doi: 10.1097/JU.0000000000001629
  • 2. EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2022: EAU Guidelines Office, Arnhem, the Netherlands; 2022.
  • 3. Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol. 2016;196(4):1161-9. doi: 10.1016/j.juro.2016.05.091
  • 4. Inoue T, Okada S, Hamamoto S, Fujisawa M. Retrograde intrarenal surgery: Past, present, and future. Investig Clin Urol. 2021;62(2):121-135. doi: 10.4111/icu.20200526
  • 5. Juliebø-Jones P, Keller EX, Haugland JN, et al. Advances in Ureteroscopy: New technologies and current innovations in the era of Tailored Endourological Stone Treatment (TEST). Journal of Clinical Urology. 2022;20514158221115986.
  • 6. Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol. 2014;24(2):179-83. doi: 10.1097/MOU.0000000000000030
  • 7. De Lorenzis E, Zanetti SP, Boeri L, Montanari E. Is There Still a Place for Percutaneous Nephrolithotomy in Current Times? J Clin Med. 2022; 11(17):5157. doi: 10.3390/jcm11175157
  • 8. Zheng C, Xiong B, Wang H, et al. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal stones >2 cm: a meta-analysis. Urol Int. 2014;93(4):417-24. doi: 10.1159/000363509
  • 9. Kang SK, Cho KS, Kang DH, Jung HD, Kwon JK, Lee JY. Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2  cm: An update. Medicine (Baltimore). 2017;96(49):e9119. doi: 10.1097/MD.0000000000009119
  • 10. Zhu M, Wang X, Shi Z, et al. Comparison between retrograde intrarenal surgery and percutaneous nephrolithotripsy in the management of renal stones: A meta-analysis. Exp Ther Med. 2019;18(2):1366-1374. doi: 10.3892/etm.2019.7710
  • 11. Ibis MA, Gokce MI, Babayigit M, Yitgin Y, Karagoz MA, Boyuk A, Verep S, Turan S, Tefik T, Kiremit MC, Sonmez MG, Ergul R, Guven S, Sarica K. Could retrograde intrarenal surgery be a safe and effective alternative to mini-percutaneous nephrolithotomy ın the management of relatively large (20-30 mm) stones? A critical evaluation. Int Urol Nephrol. 2022;54(9):2141-2148. doi: 10.1007/s11255-022-03255-9
  • 12. Fayad MK, Fahmy O, Abulazayem KM, Salama NM. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial. Urolithiasis. 2022;50(1):113-117. doi: 10.1007/s00240-021-01289-9
  • 13. Goldberg H, Golomb D, Shtabholtz Y, et al. The "old" 15 mm renal stone size limit for RIRS remains a clinically significant threshold size. World J Urol. 2017;35(12):1947-1954. doi: 10.1007/s00345-017-2075-8
  • 14. Chung KJ, Kim JH, Min GE, et al. Changing Trends in the Treatment of Nephrolithiasis in the Real World. J Endourol. 2019;33(3):248-253. doi: 10.1089/end.2018.0667
  • 15. Rodríguez-Monsalve Herrero M, Doizi S, Keller EX, De Coninck V, Traxer O. Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis. Asian J Urol. 2018;5(4):264-273. doi: 10.1016/j.ajur.2018.06.005

20-30 mm böbrek taşları için uygulanan retrograd intarenal cerrahi ve perkütan nefrolitotomi sonuçlarının karşılaştırılması: Eşleşmiş çift analizi

Year 2023, Volume: 15 Issue: 1, 9 - 15, 30.01.2023
https://doi.org/10.54233/endouroloji.1188796

Abstract

Amaç: 20-30 mm böbrek taşlarında retrograd intrarenal cerrahi ve perkütan nefrolitotomi sonuçlarını karşılaştırmayı amaçladık.
Gereç ve Yöntemler: Ocak 2013 ile Temmuz 2022 tarihleri arasında 20-30 mm böbrek taşı nedeniyle retrograd intrarenal cerrahi ve perkütan nefrolitotomi uygulanan 324 hastanın demografik, radyolojik, klinik ve cerrahi ile ilgili verileri retrospektif olarak incelendi. Tüm hastalar yapılan cerrahiye göre retrograd intrarenal cerrahi grubu ve perkütan nefrolitotomi grubu olarak iki gruba ayrıldı. Yaş, taş sayısı, taş yerleşimi, taş boyutu ve taş yoğunluğu açısından iki grup eşleştirildikten sonra 122 hasta (retrograd intrarenal grupta 61 hasta ve perkütan nefrolitotomi grubunda 61 hasta, 1:1 oranında) çalışmaya dahil edildi.
Bulgular: Retrograd intrarenal cerrahi grubu (%78.7) ve perkütan nefrolitotomi grubu (%80.2) başarı oranları benzerdi (p=0.823). Enfektif ve enfektif olmayan komplikasyonlar açısından iki grup arasında fark yoktu (sırasıyla, p=0.752 ve p=0.61). Ameliyat süresi ve hastanede yatış süresi açısından iki grup arasında istatistiksel olarak anlamlı fark vardı. Retrograd intrarenal cerrahi grubunda ortanca ameliyat süresi 70 (30-100) dakika ve ortanca hastanede kalış süresi 1 (1-28) gün, perkütan nefrolitotomi grubunda ise ortanca ameliyat
süresi 90 (50-160) dakika ve ortanca hastanede kalış süresi 4 (2-10) gün idi (p<0.001).
Sonuç: 20-30 mm böbrek taşlarının cerrahi tedavisinde retrograd intrarenal cerrahi, benzer başarı ve komplikasyon oranları, daha kısa operasyon süresi ve hastanede kalış süresi ile iyi bir alternatiftir.

References

  • 1. Tundo G, Vollstedt A, Meeks W, Pais V. Beyond Prevalence: Annual Cumulative Incidence of Kidney Stones in the United States. J Urol. 2021;205(6):1704-1709. doi: 10.1097/JU.0000000000001629
  • 2. EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2022: EAU Guidelines Office, Arnhem, the Netherlands; 2022.
  • 3. Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol. 2016;196(4):1161-9. doi: 10.1016/j.juro.2016.05.091
  • 4. Inoue T, Okada S, Hamamoto S, Fujisawa M. Retrograde intrarenal surgery: Past, present, and future. Investig Clin Urol. 2021;62(2):121-135. doi: 10.4111/icu.20200526
  • 5. Juliebø-Jones P, Keller EX, Haugland JN, et al. Advances in Ureteroscopy: New technologies and current innovations in the era of Tailored Endourological Stone Treatment (TEST). Journal of Clinical Urology. 2022;20514158221115986.
  • 6. Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol. 2014;24(2):179-83. doi: 10.1097/MOU.0000000000000030
  • 7. De Lorenzis E, Zanetti SP, Boeri L, Montanari E. Is There Still a Place for Percutaneous Nephrolithotomy in Current Times? J Clin Med. 2022; 11(17):5157. doi: 10.3390/jcm11175157
  • 8. Zheng C, Xiong B, Wang H, et al. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal stones >2 cm: a meta-analysis. Urol Int. 2014;93(4):417-24. doi: 10.1159/000363509
  • 9. Kang SK, Cho KS, Kang DH, Jung HD, Kwon JK, Lee JY. Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2  cm: An update. Medicine (Baltimore). 2017;96(49):e9119. doi: 10.1097/MD.0000000000009119
  • 10. Zhu M, Wang X, Shi Z, et al. Comparison between retrograde intrarenal surgery and percutaneous nephrolithotripsy in the management of renal stones: A meta-analysis. Exp Ther Med. 2019;18(2):1366-1374. doi: 10.3892/etm.2019.7710
  • 11. Ibis MA, Gokce MI, Babayigit M, Yitgin Y, Karagoz MA, Boyuk A, Verep S, Turan S, Tefik T, Kiremit MC, Sonmez MG, Ergul R, Guven S, Sarica K. Could retrograde intrarenal surgery be a safe and effective alternative to mini-percutaneous nephrolithotomy ın the management of relatively large (20-30 mm) stones? A critical evaluation. Int Urol Nephrol. 2022;54(9):2141-2148. doi: 10.1007/s11255-022-03255-9
  • 12. Fayad MK, Fahmy O, Abulazayem KM, Salama NM. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal pelvic stone more than 2 centimeters: a prospective randomized controlled trial. Urolithiasis. 2022;50(1):113-117. doi: 10.1007/s00240-021-01289-9
  • 13. Goldberg H, Golomb D, Shtabholtz Y, et al. The "old" 15 mm renal stone size limit for RIRS remains a clinically significant threshold size. World J Urol. 2017;35(12):1947-1954. doi: 10.1007/s00345-017-2075-8
  • 14. Chung KJ, Kim JH, Min GE, et al. Changing Trends in the Treatment of Nephrolithiasis in the Real World. J Endourol. 2019;33(3):248-253. doi: 10.1089/end.2018.0667
  • 15. Rodríguez-Monsalve Herrero M, Doizi S, Keller EX, De Coninck V, Traxer O. Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis. Asian J Urol. 2018;5(4):264-273. doi: 10.1016/j.ajur.2018.06.005
There are 15 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Research Articles
Authors

Samet Şenel 0000-0003-2280-4192

Muhammed Emin Polat 0000-0003-0271-0746

Kazım Ceviz 0000-0001-6343-383X

Emre Uzun 0000-0002-3005-2122

Yusuf Kasap 0000-0001-5313-2611

Cüneyt Özden 0000-0003-0101-6904

Antonios Koudonas 0000-0003-1834-4840

Hüseyin Cihan Demirel 0000-0001-7378-5599

Publication Date January 30, 2023
Published in Issue Year 2023 Volume: 15 Issue: 1

Cite

Vancouver Şenel S, Polat ME, Ceviz K, Uzun E, Kasap Y, Özden C, Koudonas A, Demirel HC. Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy results for 20-30 mm kidney stones: A matched-pair analysis. Endourol Bull. 2023;15(1):9-15.