Details

Autor(en) / Beteiligte

• Park, Juhyun
• Oh, Sohee
• Cho, Min Chul
• Son, Hwancheol
• Jeong, Hyeon
• Jeong, Chang Wook
• Oh, Jong Jin
• Cho, Sung Yong

Titel

The Acceptable Criterion of Stone Burden and the Significant Factors to Choose Retrograde Intrarenal Stone Surgery or Miniaturized Percutaneous Nephrolithotomy for the Treatment of Renal Stones >10 mm

Ist Teil von

• Journal of endourology, 2017-10, Vol.31 (10), p.1012

Ort / Verlag

United States

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• We investigated the surgical efficiency and cutoff criteria to determine whether retrograde intrarenal surgery (RIRS) or supine miniaturized percutaneous nephrolithotomy (MPCNL) is appropriate for managing renal stones with a mean size >10 mm. Data of a single session RIRS or supine MPCNL were collected in a prospective, observational study. Change point analysis with a cumulative sum of ordered value of fragmentation efficiency and stone size was used to detect the point at which the statistical properties of a sequence of observation change. A total of 310 RIRS and 66 MPCNL cases were included. No differences in patient characteristics were observed between the groups. Stone burden, fragmentation efficiency, stone distribution, and the presence of staghorn stones were higher in the MPCNL group than the RIRS group. Stone-free rates and complication rates were not different. The fragmentation efficiency increased to 40.4 mL/min, at which the stone size in the RIRS group was 19.1 mm. The efficiency was decreased after the peak point and became the same at the stone size 30 mm with 10 mm in RIRS group. The fragmentation efficiency in the MPCNL group continuously increased until the size of 35.1 mm. RIRS shows the highest efficiency at the maximal diameter of 19.1 mm and volume of 15,000 mm . The acceptable level of stone size and volume for RIRS would be 30.0 mm and 27,000 mm , respectively. However, MPCNL would be appropriate when surgeons want to get high surgical efficiency for renal stone >21.6 mm instead of RIRS.