Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2–3 cm

Abstract

IntroductionTo compare percutaneous nephrolithotomy and flexible ureterorenoscopy for treating kidney stones between 2 and 3cm. Material and methodsA prospective, comparative, nonrandomised study was conducted with 108 patients with kidney stones between 2 and 3cm. Fifty-four patients underwent percutaneous nephrolithotomy and 54 underwent flexible ureteroscopy. We compared the following variables: lithiasis-free rate (%), surgical time, the need for an auxiliary process, postoperative complications, hospital stay, readmission rates and recovery time. ResultsThere were no differences in the lithiasis-free rate between the 2 surgical techniques (76% for ureteroscopy vs. 87% for nephrolithotomy; p=0.1) or in the complications (29% for nephrolithotomy vs. 27% for ureteroscopy; p=0.4). A larger number of auxiliary process were needed for the ureteroscopy group (20%) than for the nephrolithotomy group (7%) (p=0.04).The surgical time was longer for the nephrolithotomy group (121±52min) than for the ureteroscopy group (93±42min) (p=0.004).The ureteroscopy group had shorter hospital stays (2.1±1.6 vs. 3.9±1.9 days; p=0.002), shorter convalescence (8.1±4.9 vs. 13.3±4.2 days; p=0.005) and higher readmission rates (7.4% vs. 0%, p=0.05) than the nephrolithotomy group. ConclusionsNephrolithotomy and ureteroscopy have similar efficacy for treating kidney stones measuring 2–3cm, with no differences in complications.Ureteroscopy results in shorter hospital stays, quicker recoveries but more readmissions and a greater need for auxiliary procedures.