Department of Urology. Karabuk University School of Medicine. Karabuk. Turkey.
Arch Esp Urol. 2021 Mar;74(2):247-253.
The current nephrolithia-sis guidelines have no recommendation about multiple calyceal stones treatment. We aimed to compare the results of two effective methods of RIRS and PNL operations in the treatment of multicalyx stones.
Data of patients who underwent RIRS or PNL for multicalyx stones between September 2014 and May 2019 in our clinic were evaluated retrospectively. In both groups, stone-free and complication rates, hospital stay, scopy times, and operation times were examined. In RIRS group, the number of sessions and total stone-free rates at the end of each session were evaluated separately.
A total of 162 patients in the RIRS group, and 103 patients in the PNL group were evaluated. After the match pair 1:1, data of 95 patients were selected in each group. Stone burden, number, density, ASA scores, BMI were similar in both groups. At the end of the first session RIRS, 59 (62.1%) patients became stone-free, while in the PNL group 73 (76.8%) patients (p: 0.027). The statistical analysis showed that the stone-free rates obtained in the second sessions in the RIRS group were similar to those of the PNL group. After a total of 124 sessions of RIRS, a stone-free rate of 81.1% was achieved by 1.3 sessions on average.
At least two session of RIRS is as effective as PNL on multiple calyceal stones. Stage RIRS can be an alternative to PNL at multicalyceal renal stones.
目前的肾结石治疗指南对多发肾盂结石的治疗没有推荐意见。我们旨在比较 RIRS 和 PNL 两种有效方法治疗多肾盂结石的结果。
回顾性分析 2014 年 9 月至 2019 年 5 月在我院行 RIRS 或 PNL 治疗的多肾盂结石患者的资料。在两组中，检查了结石清除率和并发症发生率、住院时间、镜检次数和手术时间。在 RIRS 组中，分别评估了每个疗程的次数和结束时的总结石清除率。
RIRS 组共 162 例，PNL 组 103 例。匹配 1:1 后，每组各选择 95 例患者的数据。两组的结石负荷、数量、密度、ASA 评分、BMI 相似。在 RIRS 组的第一次治疗结束时，59 例（62.1%）患者结石清除，而 PNL 组有 73 例（76.8%）（p：0.027）。统计分析显示，RIRS 组第二次治疗获得的结石清除率与 PNL 组相似。经过总共 124 次 RIRS 治疗，平均 1.3 次治疗即可达到 81.1%的结石清除率。
至少两次 RIRS 与 PNL 治疗多发肾盂结石一样有效。分期 RIRS 可作为多肾盂肾结石的 PNL 替代方案。
