In the Treatment of Lower Pole Kidney Stones Between 1-2 cm in Children, Which is the Best Approach? Retrograde Intrarenal Surgery or Mini Percutaneous Nephrolithotomy.

OBJECTIVES

Kidney stones are treated with many methods, but there is no consensus on which method should be preferred for 1-2 cm lower renal stones. In our study, we aimed to investigate the results of mini (Percutaneous Nephrolithotomy) PCNL and (Retrograde Intrarenal Surgery) RIRS in lower renal pole 1-2 cm stones.

METHODS

Twenty-four mini PCNL and 55 RIRS patients were included in the study. Demographic data of the patients and information about stones on Non-Computed Tomography (NCCT) were recorded. Stone-free status (SFR), need for additional treatment and complications of both methods were compared.

RESULTS

Operative time was 55.2±20.8 min in mini PCNL and 70.7±36.5 min in RIRS, which was statistically significantly lower (p=0.002). Length of hospital stay was 2.4±1.5 days in the mini PCNL and 1.3±0.7 days in the RIRS, which was statistically significantly longer (p=0.011). In the postoperative 1st month and 3rd month stone-free rates (SFR) were higher in the mini PCNL group. While the 1st month SFR was 91.6% and 54.5%, the 3rd month stone-free rates were 95.8% vs. 69.1%, respectively (p<0.001). The need for re-treatment was statistically lower in the mini PCNL group (p<0.001). In terms of complications, the incidence of complications was 16.6% (pain in 2 patients, fever in 1 patient, need for blood transfusion in 1 patient) in the mini PCNL group and 21.8% (pain in 2 patients, fever in 8 patients, sepsis in 2 patients) in the RIRS group. There was a significant difference between the two groups (p=0.008).

CONCLUSION

Mini PCNL has a higher SFR, less need for re-treatment and fewer complications.