Session: PD28: Stone Disease: Surgical Therapy (including ESWL) III
PD28-01: Ambulatory Tubeless Mini-Percutaneous Nephrolithotomy (Mini-PCNL) versus Retrograde Intrarenal Surgery (RIRS) in Treatment of 1-2 cm Lower Calyceal Renal Stones: A Randomized Controlled Clinical Study
Introduction: To compare the safety and efficacy of flexible ureteroscopy (F-URS) and ambulatory tubeless mini-percutaneous nephrolithotomy (mini-PCNL) in the treatment of 1-2 cm lower calyceal renal stones. Methods: Patients who underwent F-URS and mini-PCNL for the treatment of 1-2 cm lower calyceal renal stones between October 2020 and July 2022 were evaluated in a randomized controlled trial. Sixty-four participants were included in the study thus far. All participants underwent a CT renal colic scan preoperatively, on postoperative day one (POD 1), and at 3 months follow-up. Outcome measures including stone characteristics, operative time, hospital stay, stone-free rate (SFR) in addition to complications rates were collected and compared. All patients were discharged home on the same operative day. Results: There were no significant differences in preoperative baseline data between the two surgical groups. A significantly longer median operative time was reported in the mini-PCNL group (p=0.04). The median hospitalization time was 5 hours and 4 hours in the mini-PCNL and F-URS groups, respectively (p=0.14). The SFR on POD 1 was 23.5% in the F-URS group and 80% in the mini-PCNL group (p < 0.001). At 3 months follow-up, the SFR was 67.6% in the F-URS group and 90% in the mini-PCNL group (p=0.03). There was no significant difference in hemoglobin drop or postoperative complications between the two groups. One patient in the in F-URS group required retreatment. Conclusions: Ambulatory mini-PCNL and F-URS are effective treatment options for 1-2 cm lower calyceal renal stones. Both techniques have a comparable hospital stay and complication rates, with a significantly better stone-free rate with mini-PCNL. SOURCE OF Funding: None
.jpg "Loay Mostafa Ayman Mahmoud Abbas, MD,MSC photo")
