Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
Singapore Med J. 2010 Jun;51(6):512-5.
Extracorporeal shock wave lithotripsy (ESWL) is accepted as the gold standard treatment for renal stones that are smaller than 2 cm. Recently, retrograde intrarenal surgery (RIRS) has been introduced as another form of treatment. We report our experience in dealing with renal stones smaller than 2 cm using RIRS as the primary treatment and following failed ESWL.
A retrospective analysis was conducted over a five-year period on patients with stone(s) measuring less than 2 cm each and who had undergone RIRS. The patients were divided into two groups: RIRS as the primary procedure and RIRS post-ESWL.
A total of 46 patients underwent RIRS in our institute. The total stone clearance rate was 61 percent. The clearance rate was better for RIRS as the primary procedure when compared to RIRS as an adjunct procedure (70 percent versus 52 percent; p-value is 0.23). Patients with mid-pole stones achieved an 80 percent stone clearance rate as compared to 60 percent for those with lower pole stones. The clearance rate for upper pole stones was only 29 percent. When RIRS was the primary procedure for lower pole stones, the success rate was 75 percent, compared to 56 percent when it was used as an adjunct procedure post-ESWL.
For renal stones measuring less than 2 cm, the stone clearance rate for RIRS was as good as that for EWSL as a primary procedure and achieved a good clearance rate following the failure of ESWL.
体外冲击波碎石术（ESWL）被认为是治疗小于 2cm 的肾结石的金标准治疗方法。最近，逆行性肾内手术（RIRS）已被引入作为另一种治疗方法。我们报告了我们使用 RIRS 作为主要治疗方法并在 ESWL 失败后处理小于 2cm 的肾结石的经验。
对五年间在我院接受 RIRS 治疗的结石直径小于 2cm 的患者进行回顾性分析。患者分为两组：RIRS 作为主要手术和 RIRS 后 ESWL。
我院共有 46 例患者接受了 RIRS。总的结石清除率为 61%。RIRS 作为主要手术的清除率优于 RIRS 作为辅助手术（70%对 52%；p 值为 0.23）。与下极结石的 60%相比，中极结石的清除率为 80%。上极结石的清除率仅为 29%。当 RIRS 作为下极结石的主要手术时，成功率为 75%，而作为 ESWL 后的辅助手术时为 56%。
对于直径小于 2cm 的肾结石，RIRS 的结石清除率与 ESWL 作为主要治疗方法相当，并且在 ESWL 失败后也能获得良好的清除率。
