Introduction: We performed a prospective randomized comparison among Retrograde IntraRenal Surgery (RIRS) and MiniPerc (MP) for stones between 1 and 2 cm to evaluate outcomes with the same Laser device: Fiber Dust.
Methods: Patients with a single renal 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 two groups: Group A: patients treated with RIRS; Group B: patients treated with MP. Both groups underwent the procedures performed with the Fiber Dust Laser Device. Patients were followed-up with a CT scan after 3 months. A negative CT scan, or asymptomatic patients with stone fragments smaller than 3 mm and a negative urinary culture were the criteria to assess the stone-free status. A statistical analysis was carried out to assess preoperative patient data, success, complication and re-treatment rates and need for auxiliary treatment.
Results: Between January 2019 and January 2021, 186 consecutive patients were enrolled in this study. 90 pts in group A and 96 in group B. Mean stone size was 15.84 mm. in Group A and 14.99 mm. in Group B (p=0.23). The overall stone free rate was 73.3% for group A and 84.4% for group B. The higher stone-free rate was reached for upper calyceal stones in group A (19/21, 90.4%) while group B showed a better performance on lower calyceal stones (33/36, 91.6%). Retreatment rate was similar (p=0.31). Auxiliary procedure rate was comparable between group A and B (p=0.18). Complication rate was 5.5% and 5.2% for groups A and B, respectively.
Conclusions: RIRS and MP are both effective to obtain a postoperative stone free rate with fiber dust. According to the stone position one treatment is superior to the other one.
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