MP33-20 A PROSPECTIVE RANDOMIZED COMPARISON AMONG SWL, PCNL AND RIRS FOR LOWER CALYCEAL STONES LESS THAN 2 CM: A MULTICENTER EXPERIENCE

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2016MP33-20 A PROSPECTIVE RANDOMIZED COMPARISON AMONG SWL, PCNL AND RIRS FOR LOWER CALYCEAL STONES LESS THAN 2 CM: A MULTICENTER EXPERIENCE Giorgio Bozzini, Paolo Verze, Orietta Dal Piaz, Nicola Macchione, Marco Provenzano, Mauro Seveso, NicoloMaria Buffi, Boris Osmolorskji, Francesco Sanguedolce, Giorgio Guazzoni, Karl Pummer, Emanuele Montanari, and Gianluigi Taverna Giorgio BozziniGiorgio Bozzini More articles by this author , Paolo VerzePaolo Verze More articles by this author , Orietta Dal PiazOrietta Dal Piaz More articles by this author , Nicola MacchioneNicola Macchione More articles by this author , Marco ProvenzanoMarco Provenzano More articles by this author , Mauro SevesoMauro Seveso More articles by this author , NicoloMaria BuffiNicoloMaria Buffi More articles by this author , Boris OsmolorskjiBoris Osmolorskji More articles by this author , Francesco SanguedolceFrancesco Sanguedolce More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Karl PummerKarl Pummer More articles by this author , Emanuele MontanariEmanuele Montanari More articles by this author , and Gianluigi TavernaGianluigi Taverna More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1377AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We performed a prospective randomized comparison among Retrograde IntraRenal Surgery (RIRS), Schock Wave Lithotripsy (SWL) and PerCutaNeous Lithotripsy (PCNL) for lower calyceal stones between 1 and 2 cm to evaluate the efficacy and the safety of these procedures METHODS Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this multicentric study. Exclusion criteria were the presence of coagulation impairments, age less than 18 or more then 75, presence of acute infection, presence of cardiovascular or pulmonary comorbidities. Patients were randomized into three groups: Group A: patients treated with SWL; Group B: patients treated with RIRS; Group C: patients treated with PCNL. Patients were controlled with abdomen X ray and CT scan after 3 months. A negative X ray or an asymptomatic patients with stone fragments less than 3 mm big. and a negative urinary colture were the criteria to assess the stone-free status. A statistical analysis was carried out to asses patients data, success and complications rates, re-treatment rate and need for auxiliary treatment RESULTS Between January 2010 and June 2014, 582 consecutive patients were enrolled in this study. 194 pts for the group A, 207 for group B and 181 for group C. The mean stone size was 13.78 mm. in Group A, 14.82 mm. in Group B and 15.23 mm. in Group C (p=0.34). The overall stone free rate was 61.8% for group A, 82.1% for group B and 87.3 % for group C. The retreatment rate was significantly higher in group A compared to the other two groups, 61.3% (p<0.05). The auxiliary procedure rate was comparable for group A and B and lower for group C (p<0.05). The complication rate was 6.7%, 14.5% and 19.3% respectively for group A, B and C CONCLUSIONS RIRS and PCNL were more effective than SWL to obtain a better stone free rate, and less auxiliary and re-treatment rate. On the other hand for such this kind of stones PCNL had more complications mainly connected to a longer procedure time, radiation exposure and hospital stay © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e444-e445 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Giorgio Bozzini More articles by this author Paolo Verze More articles by this author Orietta Dal Piaz More articles by this author Nicola Macchione More articles by this author Marco Provenzano More articles by this author Mauro Seveso More articles by this author NicoloMaria Buffi More articles by this author Boris Osmolorskji More articles by this author Francesco Sanguedolce More articles by this author Giorgio Guazzoni More articles by this author Karl Pummer More articles by this author Emanuele Montanari More articles by this author Gianluigi Taverna More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...