Korean J Urol.  2015 Jul;56(7):525-532. 10.4111/kju.2015.56.7.525.

Comparison of retrograde intrarenal surgery versus a single-session percutaneous nephrolithotomy for lower-pole stones with a diameter of 15 to 30 mm: A propensity score-matching study

• Jung GH
• Jung JH
• Ahn TS
• Lee JS
• Cho SY
• Jeong CW
• Lee SB
• Kim HH
• Oh SJ

• KMID: 2160650
• DOI: http://doi.org/10.4111/kju.2015.56.7.525

Abstract

PURPOSE
To investigate surgical outcomes between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) groups for a main stone sized 15 to 30 mm and located in the lower-pole calyx.
MATERIALS AND METHODS
Patients who underwent PNL or RIRS for a main stone sized 15 to 30 mm and located in the lower-pole calyx were retrospectively reviewed. Each patient in the RIRS group was matched to one in the PNL group on the basis of calculated propensity scores by use of age, sex, body mass index, previous treatment history, stone site, maximum stone size, and stone volume. We compared perioperative outcomes between the unmatched and matched groups.
RESULTS
Patients underwent PNL (n=87, 66.4%) or RIRS (n=44, 33.6%). After matching, 44 patients in each group were included. Mean patient age was 54.4+/-13.7 years. Perioperative hemoglobin drop was significantly higher and the hospital stay was longer in the PNL group than in the RIRS group. The operative time was significantly longer in the RIRS group than in the PNL group. Stone-free rates were higher and complications rates were lower in the RIRS group than in the PNL group without statistical significance. The presence of a stone located in the lower-anterior minor calyx was a predictor of stone-free status.
CONCLUSIONS
RIRS and single-session PNL for patients with a main stone of 15 to 30 mm located in the lower-pole calyx showed comparable surgical results. However, RIRS can be performed more safely than PNL with less bleeding. Stones in the lower-anterior minor calyx should be carefully removed during these procedures.

Keyword

Nephrolithiasis; Renal surgery; Ureterorenoscopy

MeSH Terms

Adult
Aged
Female
Hemoglobins/metabolism
Humans
Kidney Calculi/pathology/*surgery
Length of Stay/statistics & numerical data
Male
Middle Aged
Nephrectomy/adverse effects/*methods
Nephrostomy, Percutaneous/adverse effects/*methods
Prognosis
Propensity Score
Retrospective Studies
Treatment Outcome
Hemoglobins

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