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

Yıl 2023, Cilt: 15 Sayı: 1, 9 - 15, 30.01.2023

Samet Şenel Muhammed Emin Polat Kazım Ceviz Emre Uzun Yusuf Kasap Cüneyt Özden Antonios Koudonas Hüseyin Cihan Demirel

https://doi.org/10.54233/endouroloji.1188796

Öz

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.

Anahtar Kelimeler

Percutaneous nephrolithotomy, Retrograde intrarenal surgery, Stone, Urolithiasis

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

Öz

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.

Anahtar Kelimeler

Perkütan nefrolitotomi, Retrograd intrarenal cerrahi, Taş, Ürolitiyazis

Kaynakça

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