Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stones

Abstract

To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones. This study included patients who presented with a single renal pelvic stone sized≥20mm and who were treated primarily by LP or RIRS. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis, and the surface area of the stone, operation time, hospitalization time, complications, and stone-free rates of the two groups. Of the 156 patients included in the study, 44 had LP, and 112 had RIRS. Patients who received LP (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent RIRS (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received LP were found to have larger median stone size (30mm vs 24mm, P=.003), longer operation time (100minutes vs 70minutes, P=.007), lower complication rate (2% vs 8.9%, P=.063), longer median hospital stay (3days vs 1day, P<.001) and better stone-free rate at the third month (90.9% vs 67.9%, P<.001). LP is a safe and efficient procedure that could be used as an alternative to RIRS in managing large renal pelvic stones.