The aim of the current study was to compare the outcome of minimal invasive treatment (RIRS, m
-
PCNL)
with the ESWL, Micro
-
Percutaneous Nephrolithotomy (m
-
PCNL), and Retrograde intrarenal surgery (RIRS) in patients
with renal calculi less than two centimete
rs in size.
Methods:
Preoperative renal ureter
-
bladder (KUB) film and computed tomography (CT) used to imaging stone size and
localization in all patients. Ninety consecutive patients were randomized equally to three groups. We evaluated age,
gender, stone size, lengt
h of hospitalization, stone
-
free rates, X
-
ray duration that patients were exposed during the
processes, general anesthesia time, Visual Analogue Scale values, Modified Clavien Complication Scale scores after
RIRS, mPCNL, and ESWL on renal stones smaller th
an 2 cm.
Results:
At the end of the first month, stone
-
free rate for the lower calyx stones was 33.3% (3 patients out of 10) in
ESWL, 83.3% (10 patients out of 12) in RIRS, and 90.9% (10 patients out of 11) in m
-
PCNL. ESWL's success in the
lower
-
calyx sto
nes was found to be low. Our rates for the stones in renal pelvis, middle, and upper calyx were % 85.7
(18 patients out of 21) in ESWL, % 94.4 (17 patients out of 18) in RIRS and % 94.7 (18 patients out of 19) in m
-
PCNL.
No difference was observed in the d
uration of hospitalization among patients who underwent RIRS and m
-
PCNL. The
VAS scores in ESWL group were higher than other groups. There were no significant differences for fluoroscopy time
between the groups. Decrease in hemoglobin values before and aft
er the procedure were found to be significant in m
-
PCNL group (p<0.05).
Conclusions:
We compared three minimal invasive treatments for less than 2 cm renal stones; m
-
PCNL and RIRS
methods were found to be more effective than ESWL, especially aspects of the
stone free rates.
Keywords
:
ESWL, RIRS, m
-
PCNL