Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 931-935
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.931
Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter
Mao-Mao Li, Hou-Meng Yang, Xiao-Ming Liu, Hong-Gang Qi, Guo-Bin Weng
Mao-Mao Li, Hou-Meng Yang, Xiao-Ming Liu, Hong-Gang Qi, Guo-Bin Weng, Department of Urologic Surgery, Ningbo Urology and Nephrology Hospital, Ningbo 315100, Zhejiang Province, China
Author contributions: All authors helped to perform the research; Li MM contributed to the data collection and manuscript writing; Yang HM contributed to the data analysis; Liu XM contributed to performing experiments and data analysis, Qi HG contributed to the data collection and statistical analysis; Weng GB contributed to the drafting conception and design.
Supported by the Ningbo Medical Science and Technology Project, No. 2014A33.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Ningbo Urology and Nephrology Hospital.
Informed consent statement: Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guo-Bin Weng, MD, Chief Doctor, Full Professor, Department of Urologic Surgery, Ningbo Urology and Nephrology Hospital, No. 1, Qianhe Road, Yinzhou District, Ningbo 315100, Zhejiang Province, China. ddwgb@aliyun.com
Telephone: +86-574-55662888 Fax: +86-574-55662888
Received: July 7, 2018
Peer-review started: July 10, 2018
First decision: October 8, 2018
Revised: November 1, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 6, 2018
ARTICLE HIGHLIGHTS
Research background

Retrograde intrarenal surgery (RIRS) is rapidly becoming an effective and safe treatment modality in the surgical treatment of urinary system stone disease.

Research motivation

The two surgical procedures have different advantages associated with the treatment of stones of different sizes affecting the urinary system. However, few studies have compared the results of miniaturized percutaneous nephrolithotomy (mini-PCNL) to RIRS for the treatment of lower pole stones (LP stones) with a 1.5-2.5 cm diameter.

Research objectives

This retrospective study aimed to compare the outcomes of RIRS and mini-PCNL in treating LP renal stones with a diameter of 1.5-2.5 cm.

Research methods

In this study, we reviewed retrospectively 216 patients who underwent mini-PCNL (n = 103) or RIRS (n = 113) for LP stones with a 1.5-2.5 cm diameter between December 2015 and April 2017. Specifically, we compared the operation time, stone-free rate, complications, hospital stay, and hospitalization costs in patients treated by these two minimally invasive methods.

Research results

Significant differences were found in the hospital stay (9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs (2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operative time was not significantly different between the RIRS group (56.48 ± 24.77) and the mini-PCNL group (60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day (RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively (RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different.

Research conclusions

Our results showed that both RIRS and mini-PCNL are safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment of LP stones of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment of LP stones of 1.5-2.5 cm. Our study added another argument for making RIRS the optimal choice in an increasing number of stone cases.

Research perspectives

First, we used X-rays and ultrasound to determine stone-free rates in the postoperative period although CT is a more specific and sensitive procedure. Second, the sample size was comparatively small. Third, there were potential differences in the preparation and management protocols of the patients in this retrospective study. Prospective studies controlling for such variables with large samples will allow a more robust evaluation of these phenomena. RIRS can be considered as an alternative to PCNL for the treatment of LP stones of 1.5-2.5 cm. Future studies with larger sample sizes are required to replicate and extend these findings.