scholarly journals Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for lower calyx renal stones

2021 ◽  
Vol 12 (10) ◽  
pp. 111-116
Author(s):  
Ershad Hussain Galeti ◽  
Saqib Shahab ◽  
Mriganka Deuri Bharali ◽  
Rajaboina Yakaiah
Keyword(s):  
Hospital Stay ◽  
Pain Score ◽  
Percutaneous Nephrolithotomy ◽  
Visual Analog Score ◽  
Clearance Rates ◽  
Retrograde Intrarenal Surgery ◽  
Analgesic Requirement ◽  
Stone Clearance ◽  
Operative Duration ◽  
Hemoglobin Drop

Background: Due to the anatomic characteristics of the lower calyx, lower polar stones are difficult to be removed through the ureter, retrograde intrarenal surgery (RIRS) can be used to deal with lower polar stones, while mini-percutaneous nephrolithotomy(mini-PCNL) is mainly used to deal RIRS failed to eliminate the stone. Aims and Objectives: Prospective comparison of mini-PCNL and retrograde intrarenal surgery outcomes in lower calyx managementwith respect to surgery duration, pain score (visual analog score), analgesic requirement, hemoglobin drop, and hospital stay. Materials and Methods: This is a prospective study in 50 patients (25 cases of RIRS and 25 cases of MINIPERC) over 2 years who came to the urology departme with lower calyx stone of size up to 20mm. The selection of the management methods was primarily based on the patient’s preferences. Preoperatively, all patients underwent routine workup and CT KUB plain. The primary and secondary objective was stone clearance rates, retreatment rate, complications, surgical duration, pain score (visual analog score [VAS]), analgesic requirement, hemoglobin drop, and hospital stay. Results: Miniperc and RIRS had stone clearance rates of 100% and 96%, respectively. In the RIRS group, one patient required retreatment for 1month. Hospital stay, intraoperative and post-operative complications were non-significant between both groups. Operative duration (P=0.003) was lower in the Miniperc group. Hemoglobin drop (P<0.0013), patient pain, and visual analog scale score at 6, 24, and 48 h, as well as an analgesic requirement (P<0.020), were all lower in the RIRS group. Conclusion: The stone clearance rates in both modalities are high, and complications are low. RIRS requires a longer operative duration, and it is associated with favorable pain scores and a lower hemoglobin drop.

scholarly journals Retrograde Intrarenal surgery- Our experience

2020 ◽  
Vol 3 (1) ◽  
pp. 88-92
Author(s):  
Nand Kumar B. Madhekar ◽  
A. Nischal Prasad
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Tertiary Care ◽  
Renal Stones ◽  
Tertiary Care Centre ◽  
Renal Surgery ◽  
Retrograde Intrarenal Surgery ◽  
Residual Stone ◽  
Stone Clearance ◽  
Residual Stones

Background: RIRS has become an important treatment option for kidney stones in pediatric patients with the development of new-generation ureteroscopy and holmium laser. The present study was conducted to assess cases of retrograde intrarenal surgery. Subjects and Methods: The present study was conducted in a tertiary care centre over a period of one year on 120 cases of retrograde intra renal surgery (RIRS) performed in both genders. Renal stone location and stone clearance, laterality, stone size, operative time, hematuria, postoperative pain & fever, urosepsis, hospital stay, residual stones and need of an adjunctive procedure to achieve residual stone clearance. Results: Out of 120 patients, males were 70 and females were 50. Stones were detected in upper calyx in 50 cases, middle calyx in 40, lower calyx in 20 and pelvis in 10 cases. The mean size of stones was 8.1 mm, operative time was 62.1 minutes, hospital stay was 3.6 days, clinically insignificant radiological fragments were seen in 35 cases and residual stones were seen in 20 cases. Maximum cases of CIRF were seen in middle calyx (15) and residual stones were seen in lower calyx (7). The difference was significant (P< 0.05). Common complications were fever in 7, hematuria in 3, flank pain in 4 and urosepsis in 2 cases. Conclusion: Authors found that retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal stones.

Comparison of Retrograde Intrarenal Surgery and Micro-Percutaneous Nephrolithotomy for Kidney Stones: A Meta-Analysis

2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Gu ◽  
Yucheng Yang ◽  
Rui Ding ◽  
Meili Wang ◽  
Jianming Pu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
Retrograde Intrarenal Surgery ◽  
Alternative Approach ◽  
Significant Difference

<b><i>Background:</i></b> Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. <b><i>Objectives:</i></b> The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. <b><i>Methods:</i></b> A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. <b><i>Results:</i></b> Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, <i>p</i> = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, <i>p</i> = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, <i>p</i> = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, <i>p</i> &#x3c; 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, <i>p</i> = 0.04) when comparing RIRS with micro-PCNL. <b><i>Conclusions:</i></b> Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.

scholarly journals Outcomes of Retrograde Intra-Renal Surgery

2019 ◽  
Vol 2 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Samir Shrestha ◽  
Pukar Maskey
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Renal Calculi ◽  
Renal Surgery ◽  
Surgical Morbidity ◽  
Retrograde Intrarenal Surgery ◽  
Stone Clearance ◽  
The Mean

Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.

scholarly journals Comparison of Tubeless Mini Percutaneous Nephrolithotomy with Conventional Technique in a Tertiary Care Center

2022 ◽  
Vol 19 (1) ◽  
pp. 34-36
Author(s):  
Dipesh Kumar Gupta ◽  
Arun Gnyawali ◽  
Deepak Jaiswal
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Care Center ◽  
Tertiary Care ◽  
Postoperative Blood Loss ◽  
Routine Practice ◽  
Standard Group ◽  
Nephrostomy Tube ◽  
Analgesic Requirement

Introduction: Mini Percutaneous Nephrolithotomy (mPCNL) is a safe and efficient method for management of nephrolithiasis. Post procedure nephrostomy tube drainage is considered as the standard practice. In recent years, tubeless mPCNL with the use of double J (DJ) stent alone has replaced the placement of the nephrostomy tube. Aims: This study intends to evaluate the safety and efficacy of tubeless Mini Percutaneous Nephrolithotomy. Methods: A total of 80 patients with Nephrolithiasis, admitted to Urology Unit of Nepalgunj Medical College, between September 2018 and September 2019 were enrolled in the study and divided into two groups: Tubeless group where tube was omitted and Standard Group where it was placed. The two groups were compared with respect to hemoglobin drop and blood transfusion requirement, hospital stay and analgesic requirement in the post-operative period. Results: Mean age of the patients was 34.30 ± 13.19 years. Mean stone size was 19.03 mm. The mean change in hemoglobin after standard mPCNL was 1.68 gm/dl and that in the tubeless group was 1.11 (p=0.018). The tubeless group had a significantly (p=0.001) shorter hospital stay (3.05 ± 1.23 days) compared to standard group (3.85 ± 0.86). The postoperative pain as assessed by visual analogue scale, was more in the standard group necessitating additional analgesia. It was significantly higher in the standard group at 12, 24, 48 hours, as compared to the tubeless group. Conclusion:  Placement of nephrostomy tube can be omitted as a routine practice as Tubeless mini PCNL has an added advantage of significantly reduced postoperative pain, less analgesic requirement, shorter hospital stay, less postoperative blood loss.

scholarly journals Comparative Study Between Mini PCNL and RIRS in the Treatment of Renal Stones <20mm : Our Experience in CMH Dhaka

2020 ◽  
Vol 23 (2) ◽  
pp. 199-204
Author(s):  
Md Abdur Rakib ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed ◽  
Md Ashif Chwdhury ◽  
Mohammad Shafiul Alam ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Renal Stones ◽  
Renal Calculi ◽  
Hemoglobin Level ◽  
Clearance Rates ◽  
Open Label ◽  
Stone Clearance ◽  
Level Data ◽  
The Mean ◽  
Study Participants

Aim: The aim of this study is to compare the outcomes of miniaturized percutaneous nephrolithotomy (mini-perc) and retrograde intrarenal surgery (RIRS) in management of renal stones with a diameter <15 mm. Materials and Methods: This was an open-label prospective study that included a total of 80 cases underwent mini-perc (n = 40) and RIRS (n = 40) between July 2014 and August 2017. The primary outcome objective was stone-free rate, retreatment rate, complications, hospital stay, operative time, and reduction in hemoglobin level. Data were analyzed using SPSS version 16.0 Software. Results: Overall, 80 patients were enrolled in this study. The mean age was 40.12 and 38.20 years, and the mean stone size was 1.15 and 1.30 cm in mini-perc and RIRS group, respectively. Majority of the study participants were males. Overall, mini-perc and RIRS had stone clearance rates of 100% and 95.4%, respectively. Two patients required retreatment in RIRS group. The duration of hospital stay and the rate of complication was similar in both the groups. Operative duration was more in RIRS group. Decrease in hemoglobin level was more in mini-perc group. Conclusions: Results demonstrated that both modalities were associated with high stone clearance rates with minimal complications. RIRS was associated with less reduction in hemoglobin and could be used as standard treatment modality for small renal calculi. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.199-204

scholarly journals Comparison of standard and tubeless percutaneous nephrolithotomy for renal calculi: a prospective randomized control trial

2019 ◽  
Vol 6 (4) ◽  
pp. 185
Author(s):  
Manu Muraleedharan Kamalakshi ◽  
Vasantharaja Ramasamy ◽  
Darsan Sadasivan ◽  
Sunil Raveendran ◽  
Selvam Paramasivam ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Randomized Control Trial ◽  
Renal Stones ◽  
Renal Calculi ◽  
Analgesic Requirement ◽  
Operative Duration ◽  
Significant Difference ◽  
Randomized Control ◽  
Tubeless Pcnl

<p class="abstract"><strong>Background:</strong> In the current era of minimally invasive interventions, the mainstay of treatment of renal stones larger than 2 cm is Percutaneous nephrolithotomy (PCNL). PCNL underwent various evolutionary changes minimizing morbidity to the patients. We prospectively compared the outcome of tubeless PCNL (without nephrostomy drainage tube) to reduce the pain and discomfort caused by tube with standard PCNL in the treatment of renal stones.</p><p class="abstract"><strong>Methods:</strong> In this Randomized control trial (RCT), we divided patients satisfying the inclusion criteria of consenting for trial, single access puncture, less than 3 stones each less than 3 cm, operative duration of less than 2 hours into two groups, standard PCNL (group 1) and tubeless PCNL (group 2) with 25 patients each. Randomization and group assignment were done after complete clearance of renal stones.</p><p class="abstract"><strong>Results:</strong> Patient’s age, gender, sides of stone and stone size were comparable between two groups (standard versus tubeless PCNL). Postoperative hemoglobin drop, bleeding, pyrexia, urine leak, and blood transfusion requirement did not show a statistically significant difference between the two groups. Analgesic requirement (190 mg versus 80 mg of tramadol), operative duration (49.80 min versus 38.60 min), postoperative pain score (6/10 versus 3.64/10-visual analog scale) and duration of hospital stay (68.48 hours versus 41.12 hours) showed statistically significant difference favoring tubeless PCNL.</p><p class="abstract"><strong>Conclusions: </strong>Tubeless PCNL may be a safe, acceptable and effective modality of treatment for renal calculi in carefully selected patients comparing standard PCNL resulting in less operative duration, lower postoperative pain, reduced analgesic requirement and shorter hospital stay.</p>

scholarly journals Retrograde Intrarenal Surgery vs. Miniaturised Percutaneous Nephrolithotomy to Treat Lower Pole Renal Stone < 2 cms Diameter in Western Part of Odisha

2021 ◽  
Vol 8 (19) ◽  
pp. 1347-1351
Author(s):  
Ashok Kumar Nayak ◽  
Sanjay Kumar Mahapatra ◽  
Braja Mohan Mishra ◽  
Dipti Ranjan Dhar ◽  
Biswajit Sahu
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operating Time ◽  
Operation Time ◽  
Renal Stones ◽  
Analysis Data ◽  
Lower Pole ◽  
Medical Sciences ◽  
Retrograde Intrarenal Surgery ◽  
The Mean

BACKGROUND We wanted to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of < 2 cm in terms of safety, efficacy, and stonefree rate (SFR). METHODS In a retrospective analysis data of 39 patients who underwent mini-PCNL (N = 19) or RIRS (N = 20) for LP stones with a diameter of < 2 cm were reviewed between November 2018 and November 2020 at the Department of Urology in Veer Surendra Sai Institute of Medical Sciences and Research (VSSIMSAR), Odisha. The mean age, sex, stone size, operating time, complications, hospital stay, and SFR were compared between the groups. The success of the procedure was defined as the absence of residual stones or small residuals of size 3mm or less on computed tomography at 12 weeks postoperatively. RESULTS Significant differences were found in the hospital stay duration in hours (103.3 ± 11.7 vs. 145.2 ± 16.4, P < 0.028) between the RIRS and mini - PCNL groups. The mean operation time (in minutes) was also significantly different between the RIRS group (82.5 ± 3.44) and mini PCNL group (86.21 ± 5.90, P = 0.021). The stonefree rates in the postoperative period at three months (RIRS vs. mini - PCNL: 95 % vs. 94 %, P = 0.47) were not significantly different. CONCLUSIONS RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of < 2 cm. RIRS can be considered as a less invasive alternative to PCNL for the treatment of LP stones of < 2 cm with reasonable SFR with shorter hospital stay. KEYWORDS Retrograde Intrarenal Surgery, Percutaneous Nephrolithotripsy, Lower Pole Kidney Stones, Miniaturized Percutaneous Nephrolithotomy

scholarly journals Comparative Study Between Percutaneous Nephrolithotomy and Extra Corporeal Shock Wave Lithotripsy in Managing Renal Stones

2014 ◽  
Vol 41 (3) ◽  
pp. 23-27
Author(s):  
MS Islam ◽  
NP Biswas ◽  
MZ Hossan ◽  
I Rahman ◽  
AKM K Alam ◽  
...  
Keyword(s):  
Shock Wave ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Cutaneous Fistula ◽  
Stone Clearance ◽  
Post Procedure ◽  
Significant Difference

To find out better treatment option in treating renal stone safely, expeditiously. A total of 90 patient were prospectively randomized for Percutaneous Nephrolithotomy (PCNL) (40) and Extra Corporeal Shock Wave Lithotripsy (ESWL) (50). Stone clearance, adjuvant procedures, hospital stay, post procedure morbidity, were compared for both methods. Stone clearance in PCNL and ESWL group was 87.50 and 66 percent respectively with a significant difference of clearance (P<0.05). Considering the stone size, in smaller stones, clearance was 87.50% and 72 50% among PCNL and ESWL group respectively without any significant difference (P>0.05). But in larger stones, stone clearance was 87.50% and 60.72% among PCNL and ESWL group respectively with significant difference in clearance between the groups (P<0.05). The rate of adjuvant procedures in PCNL and ESWL group was 12.50%, and 34% respectively. Requirement of adjuvant procedures were significantly higher in ESWL group (P<0.051 Post procedure hospital stay was significantly shorter in ESWL group than PCNL group (1.32 0.47 vs 4.52 1.99) with P yalue <0 05. Steinstrasse and Haematuria were significantly higher in ESWL group than PCNL group. Bleeding requiring transfusion, urinary cutaneous fistula and .fever were significantly higher in PCNL group than ESWL group. PCNL is more effective than ESWL in clearing larger renal stones. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18954 Bangladesh Medical Journal 2012 Vol.41(3): 23-27

scholarly journals Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

2018 ◽  
Vol 16 (3) ◽  
pp. 274-278
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Operating Time ◽  
Lower Pole ◽  
Stone Size ◽  
Stone Clearance ◽  
Minimally Invasive Surgical ◽  
The Mean ◽  
Complications Rate

Background:  Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones.Methods: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study. The  operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.

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