Urologia Internationalis
Original Paper
Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mmOzturk U.a · Sener N.C.b · Goktug H.N.G.a · Nalbant I.c · Gucuk A.d · Imamoglu M.A.aaDepartment of Urology, Ankara Dışkapı Yıldırım Beyazit Education and Research Hospital, and bNumune Teaching and Research Hospital, Department of Urology, Adana, Turkey; cDepartment of Urology, Yenimahalle State Hospital, Ministry of Health, Ankara, and dDepartment of Urology, AIBU School of Medicine, Bolu, Turkey
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: September 18, 2012
Accepted: April 05, 2013
Published online: June 28, 2013
Issue release date: October 2013
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 2
ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)
For additional information: https://www.karger.com/UIN
Abstract
Objective: To compare the results of percutaneous nephrolithotomy (PCNL), shock wave lithotripsy (SWL), and retrograde intrarenal surgery (RIRS) for 1- to 2-cm lower pole kidney stones. Patients and Methods: This retrospective study was based on data collected from the files of patients between January 2007 and May 2012. The files of 383 patients (221 SWL, 144 PCNL, 38 RIRS) were evaluated. The groups were compared for stone size, success rate, and complication rate using the modified Clavien grading system. Results: The stone burdens of the groups were similar (p = 0.36). The success rates were 76, 94, and 73%, respectively, in SWL, PCNL, and RIRS. The highest stone-free rate was in the PNL group (p < 0.05). When the complication rates were evaluated using the Clavien grading system, they were determined to be 13% in PCNL, 3% in SWL, and 5% in RIRS. Especially GII and GIII complications were more common in the PCNL group (p < 0.05). Conclusion: PCNL seems to be the most successful but most invasive method. However, with relatively low complication rates, SWL and RIRS are other techniques to keep in mind. To determine the first-line treatment, prospective randomized studies with larger series are needed.
© 2013 S. Karger AG, Basel
Related Articles:
References
-
Turk C, Knoll T, Petrik A, Sarika K, Seitz C, Straub M, et al: Guidelines on urolithiasis. European Association of Urology. 2012. http://www.uroweb.org/publications/eau-guidelines/.
- Chen EH, Nemeth A: Complications of percutaneous procedures. Am J Emerg Med 2011;29:802-810.
- Preminger G: Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urol Res 2006;34:108-111.
- Kanao K, Nakashima J, Nakagawa K: Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy. J Urol 2006;176:1453-1456.
- Baykal M, Muslumanoglu A, Tefekli A: A prospective, randomized trial of management for asymptomatic lower pole calculi. J Urol 2010;183:1424-1428.
- Goktas C, Akca O, Horuz R, Gokhan O, Albayrak S, Sarica K: SWL in lower calyceal calculi: evaluation of the treatment Results in Children and Adults. Urology 2011;78:1402-1406.
- Frattini A, Ferretti S, Arena F, Larosa M, Cortellini P: Extracorporeal shockwave lithotripsy (ESWL): our experience. Acta Biomed Ateneo Parmense 1995;66:5-10.
- Jang YB, Kang KP, Lee S, Kim W, Kim MK, Kim YG, et al: Treatment of subcapsular haematoma, a complication of extracorporeal shock wave lithotripsy (ESWL), by percutaneous drainage. Nephrol Dial Transplant 2006;21:1117-1118.
- Hidalgo Pardo F, Conte Visús A, Rebassa Llull M, Losada González P, Gutiérrez Sanz-Gadea C, Ozonas Moragues M: Rectorrhage as an unusual extrarenal complication after ESWL. Actas Urol Esp 1998;22:366-368.
- Kastelan Z, Derezic D, Pasini J, Stern-Padovan R, Skegro M, Mrazovac D, et al: Rupture of the spleen and acute pancreatitis after ESWL therapy: a rare complication. Aktuelle Urol 2005;36:519-521.
- Yuruk E, Binbay M, Sari E, Akman T, Altinyay E, Baykal M, et al: A prospective, randomized trial of management for asymptomatic lower pole calculi. J Urol 2010;183:1424-1428.
- Lehtoranta K: Cost and effectiveness of different treatment alternatives in urinary stone practice. Scand J Urol Nephrol 1995;29:437-447.
- Knoll T, Wendt-Nordahl G, Alken P: Clinical value of percutaneous nephrolithotomy. Urologe A 2005;44:299-306.
- Gunes A, YahyaUgras M, Yilmaz U, Baydinc C, Soylu A: Percutaneous nephrolithotomy for pediatric stone disease - our experience with adult-sized equipment. Scand J Urol Nephrol 2003;37:477-481.
- Ozden E, Sahin A, Tan B, Doğan HS, Eren MT, Tekgül S: Percutaneous renal surgery in children with complex stones. J Pediatr Urol 2008;4:295-298.
- Skolarikos A, de la Rosette J: Prevention and treatment of complications following percutaneous nephrolithotomy. Curr Opin Urol 2008;18:229-234.
- Johnson GB, Portela D, Grasso M: Advanced ureteroscopy: wireless and sheathless. J Endourol 2006;20:552-555.
- Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD: Holmium: YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 2002;167:31-34.
- Johnson GB, Grasso M: Exaggerated primary endoscope deflection: initial clinical experience with prototype flexible ureteroscopes. J Urol 2004;93:109-114.
- Gross AJ, Fisher M: Management of stones in patients with anomalously sited kidneys. Curr Opin Urol 2006;16:100-105.
- Srisubat A, Potisat S, Lojanapiwat B, et al: Extracorporeal shock wave lithotripsy versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev 2009;7:CD007044.
- Zhong W, Zeng G, Wu W, Chen W, Wu K: Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res 2011;39:117-122.
- Monga M, Oglevie S: Minipercutaneous nephorlithotomy. J Endourol 2000;14:419-421.
- Desai M, Mishra S: ‘Microperc' micro percutaneous nephrolithotomy: evidence to practice. Curr Opin Urol 2012;22:134-138.
Article / Publication Details
Received: September 18, 2012
Accepted: April 05, 2013
Published online: June 28, 2013
Issue release date: October 2013
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 2
ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)
For additional information: https://www.karger.com/UIN
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
