Lee YJ, Bak DJ, Chung JW, Lee JN, Kim HT, Yoo ES, Kim BS. Is it necessary to actively remove stone fragments during retrograde intrarenal surgery?
Investig Clin Urol 2016;
57:274-9. [PMID:
27437537 PMCID:
PMC4949691 DOI:
10.4111/icu.2016.57.4.274]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/20/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose
Based on the experiences of our center, we sought to verify the necessity of actively removing stones during retrograde intrarenal surgery (RIRS) for the management of renal stones.
Materials and Methods
From March 2010 to March 2015, 248 patients underwent RIRS at our center. We classified these patients into 2 groups according to the performance of active stone removal; group A (n=172) included the patients whose stones were actively removed using a stone basket, and group B (n=76) included the patients whose stones were fragmented with laser lithotripsy without active removal of the fragments. We retrospectively compared the operation time, success rate, and complication rate between the 2 groups.
Results
There were no significant differences between groups A and B in terms of mean age (56.1 years vs. 58.6 years), male to female ratio (115:57 vs. 46:30), mean body mass index (24.5 kg/m2 vs. 25.0 kg/m2), mean preoperative size of stone (11.1 mm vs. 11.1 mm), the ratio of unilateral and bilateral stones (136:36 vs. 64:12), success rate (89.0% vs. 86.8%), operation time (82.5 minutes vs. 82.1 minutes), overall complication rate (9.9% vs. 11.8%), incidence of febrile urinary tract infection (6.4% vs. 2.6%), gross hematuria (1.7% vs. 2.6%), or postoperative de novo hydronephrosis (2.9% vs. 5.3%).
Conclusions
This study demonstrated that during RIRS, fragmentation only, without the active removal of stones, is a safe and effective technique in which the surgical outcomes are comparable to those of procedures involving the active removal of stones.
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