Category: Clinical Stones: PCNL

MP26-16 - Endourological management of renal calculi of 1 to 2 cm size, tubeless mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery, who is the winner?

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

To compare the safety, efficacy and outcome of minimally invasive percutaneous nephrolithotomy (mini-PCNL) and retrograde intra-renal surgery (RIRS) for renal stones measuring 1 to 2 cm of size.

Methods :

Data was collected retrospectively from patients record. Total 80 patients were enrolled in our study. These patients were randomly divided in two equal groups. Group A comprised of RIRS operative procedure while Group B was managed by Mini PCNL. Operative time, duration of hospital stay, pre-operative and post-operative differences of lab parameters, intra and post operative hematuria, need of blood transfusion, residual stone and need of other procedure were compared between these two groups. Mean ± Std were obtained for normally distributed continuous variables while for skewed data median with IQR was observed. N with % was described for categorical variables. To see the difference between continuous parameters, Independent student t test was used for normal data, on the other hand for nonparametric variables, Man Whitney test was applied. To observe the association of categorical variables with RIRS and Mini PCNL chi square test was used. Level of significance was considered as ≤ 0.05 (5%).

Results :

Mean age of our patients was 37.7 ± 10.8 in RIRS group, while 47 ± 15 in Mini PCNL. Duration of hospital stay was longer in Mini PCNL group as compare to RIRS group, which was significant (p < 0.001.Mean drop of hemoglobin in Mini PCNL was higher (0.88 mg/dl ± 2.38) as compare to RIRS group (0.08 mg/dl ± 0.34) all other lab parameters were same in both groups. Table-1.

In our study, Mean operative time was longer in RIRS operative procedure as compare to mini-PCNL and this difference was significant statistically (p < 0.001). Residual stone and need for other procedure were significantly associated with RIRS (p ≤ 0.05). While post-operative complications had no association with both these operative procedure (p > 0.05). Table-2

Conclusions :

Both mini-PCNL and RIRS are endourological options for management of renal stone measuring 1 to 2 cm. While comparing both these armamentarium, mini percutaneous nephronephrolithotomy (mini-PCNL) is more invasive but having better stone free rates and is safe  without any serious complications, however  RIRS is least  invasive but has reduced stone free rates, longer operative time and may require further intervention for stone clearance.

Anees Soomro

Lecturer Urology
Tabba Kidney Institute
Karachi, Sindh, Pakistan

I did my graduation in 2008 from Dow university of Health sciences Karachi.
I did my general surgery training from 2009 to 2012 from Jinnah Post Graduate Medical Centre, Karachi
I did my urology training from december 2012 to september 2016 from Sindh Institute of Urology & Transplatation Karachi

Sherjeel Saulat

Head of Department Urology
Tabba Kidney Institute
Karachi, Sindh, Pakistan

Murtaza Azad

Senior Registrar Urology
Tabba Kidney Institute
Karachi, Sindh, Pakistan

Saeed Qadri

karachi, Sindh, Pakistan