MP28-20 COMPARISON OF FLEXIBLE URETERORENOSCOPY AND MINI PERCUTANEOUS NEPHROLITHOTOMY IN TREATMENT OF LOWER CALYCEAL STONES SMALLER THAN 2 CM

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2015MP28-20 COMPARISON OF FLEXIBLE URETERORENOSCOPY AND MINI PERCUTANEOUS NEPHROLITHOTOMY IN TREATMENT OF LOWER CALYCEAL STONES SMALLER THAN 2 CM Mehmet Fatih Akbulut, Onur Kucuktopcu, Emre Kandemir, Erkan Sonmezay, Abdulmuttalip Simsek, Faruk Ozgor, Murat Binbay, Ahmet Yaser Muslumanoglu, and Zafer Gokhan Gurbuz Mehmet Fatih AkbulutMehmet Fatih Akbulut More articles by this author , Onur KucuktopcuOnur Kucuktopcu More articles by this author , Emre KandemirEmre Kandemir More articles by this author , Erkan SonmezayErkan Sonmezay More articles by this author , Abdulmuttalip SimsekAbdulmuttalip Simsek More articles by this author , Faruk OzgorFaruk Ozgor More articles by this author , Murat BinbayMurat Binbay More articles by this author , Ahmet Yaser MuslumanogluAhmet Yaser Muslumanoglu More articles by this author , and Zafer Gokhan GurbuzZafer Gokhan Gurbuz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1243AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare the outcomes of flexible ureterorenoscopy and mini percutaneous nephrolithotomy in the treatment of lower calyceal stones smaller than 2 cm. METHODS Patients who underwent flexible ureterorenoscopy (F-URS) and mini percutaneous nephrolithotomy (miniPNL) for the treatment of lower calyceal stones smaller than 2 cm between March 2009 and February 2014 were retrospectively evaluated. Each group included 20 patients. All patients were preoperatively diagnosed with intravenous pyelography or computed tomography. Operations which are resulted as clinically insignificant residual fragments (CIRF) or completely stone free were evaluated as successful operations. Comparison of final results was performed according to the percentages of successful operations. RESULTS Success rates for F-URS and miniPNL at post operative early days were 80% and 85% respectively. Post operative first month success rates were 85% and 90% for F-URS and miniPNL patients respectively. Operation time, fluoroscopy time and hospitalisation time for F-URS and miniPNL patients were 63.10 minutes, 2.4 minutes, 28.3 hours and 105.16 minutes, 7.05 minutes, and 76.8 hours, respectively. All three parameters were significantly shorter among the F-URS group (p<0.001). Peroperative haemoglobin drop did not differ significantly (p=0.618). A comparison of complications according to the Clavien classification demonstrated significant differences between the groups (p=0.019). More patients in the F-URS groups developed fever that required antibiotics, and more patients in the miniPNL group required ureteral double J (DJ) catheter insertion under general anaesthesia. CONCLUSIONS Although both F-URS and miniPNL have similar success rates for the treatment of lower calyceal stones, F-URS appears to be more favourable due to shorter fluoroscopy and hospitalisation times. Table 1. Preoperative patient demographics F-URS miniPNL All Patients P Value Number 20 20 40 Gender 0.311 Male 12 15 27 Female 8 5 13 Age (years) 45.75±12.98 39.84±17.815 42.87±15.60 0.242 BMI (Kg/M2) 28±8.19 27.22±4.27 27.90±6.48 0.317 Stone area (mm2) 191.65±52.50 202.75±97.50 197.20±77.50 0.657 Opacity 0.292 Opaque 17 19 36 Non-opaque 3 1 4 Hydronephrosis 0.149 0 7 2 1 7 13 2 2 3 3 3 1 4 0 1 Side of surgery 0.022 Left 9 16 25 Right 11 4 15 History of renal stone surgery 0.507 Primary 14 12 26 Secondary 6 8 14 BMI: Body mass index Table 2. Comparison of surgical results between the operation groups F-URS miniPNL P Value Operation time (min) 63.10±27.12 105.16±38.25 <0.001 Fluoroscopy time (min) 2.4±1.39 7.05±4.26 <0.001 Hospitalisation time (hours) 28.30±33.67 76.80±29.75 <0.001 Haemoglobin drop (mg/dl) 0.38±0.97 0.15±1.78 0.618 Stone fragmentation device 0.07 No fragmentation 0 1 Laser 20 14 Laser pneumatic 0 1 Ultrasonic 0 4 Clavien score 0.019 1 0 2 2 4 0 3A 0 0 3B 1 6 4 0 0 5 0 0 Result 0.11 CIRF 7 2 Residual stone 4 3 Stone-free 9 15 CIRF: Clinically insignificant residual fragments © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e318 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mehmet Fatih Akbulut More articles by this author Onur Kucuktopcu More articles by this author Emre Kandemir More articles by this author Erkan Sonmezay More articles by this author Abdulmuttalip Simsek More articles by this author Faruk Ozgor More articles by this author Murat Binbay More articles by this author Ahmet Yaser Muslumanoglu More articles by this author Zafer Gokhan Gurbuz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...