Comparison of retrograde intra-renal surgery and percutaneous nephrolithotomy in treating renal pelvic stone less than 1 .5 centimeters
10.3969/j.issn.1005-6483.2015.02.012
- VernacularTitle:逆行肾内手术与经皮肾镜碎石术治疗直径小于1.5 cm 肾盂结石的疗效比较
- Author:
Qiang XIAO
;
Yanchun HUANG
- Publication Type:Journal Article
- Keywords:
renal pelvic calculus;
retrograde intra-renal surgery;
percutaneous nephrolitho-tomy;
holmium laser lithotripsy
- From:
Journal of Clinical Surgery
2015;(2):113-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the best minimal invasive method in treating renal pelvic stones less than 1.5 cm.Methods A total of 90 patients with renal pelvic stone less than 1.5 cm were enrolled, including 47 cases of retrograde intrarenal surgery(RIRS)by rigid and flexible ureteroscopy with holmium laser lithotripsy,and 43 cases of percutaneous nephrolithotomy(PCNL)by holmium laser lithotripsy.Opera-tion time,stonefree rate(SFR),hospitalization,and complications were analyzed for comparison.Results The average sizes of stone in the RIRS group and PCNL group were 1.2 cm(range 1.0 ~1.5 cm)and 1.3 cm (1.0 ~1.5 cm),respectively.In the RIRS group,45(95.74%)patients out of 47 had complete clearance and 32 patients needed combination of flexible ureteroscopy to fragmentate the stones falling into the renal calices.The operation time was 44 min(range 27 ~70 min)with postoperative fever in 2 cases.The decrea-sing in hemoglobin and hematocrit was(0.18 ±0.06)g/L and 0.11%,respectively.No major complication was recorded.In PCNL group,the mean operation time was 70min(range 45 ~90 min)with a stone-free rate of 95.35%(41 /43).The decreasing in hemoglobin and hematocrit was(17.25 ±6.70)g/L and 5. 62%,respectively.The complications in PCNL group were postoperative fever in two cases and bleeding in two cases.Conclusion RIRS has the advantages of natural orifice endoscopic surgery in shortening opera-tion time,reducing blood transfusion requirements,and decreasing postoperative complications.For renal pelvic stone less than 1.5 cm,RIRS can be the primary choice.
