Babak Javanmard1, Amir Hossein Kashi2, Mohammad Mohsen Mazloomfard3, Anahita Ansari Jafari4, Saeed Arefanian5. 1. Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. drbabakjavanmard@gmail.com. 2. Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran. 3. Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 4. Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Department of Surgery, School of Medicine, Washington University in St. Louis, Saint Louis, Missouri, United States.
Abstract
PURPOSE: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (SWL) for stones ≤ 2 cm. MATERIALS AND METHODS: Patients who were diagnosed with kidney stones of ≤ 2 cm underwentRIRS or SWL in a parallel group randomized clinical trial with balanced randomization [1:1] from 2011 to 2014. The primary outcome of interest was stone free rate after a single session intervention. Patients were evaluated by ultrasonography and KUB at 1 and 3 months after the intervention for the presence of residual stone by a radiologist who was blinded to the study. RESULTS: The stone free rate one month after a single session intervention in the RIRS group was higher than the SWL group (90% versus 75%, P = .03). The success rates after two sessions of RIRS versus SWL were 96.7% versus 88.3% respectively. (P = .08) Patients in the RIRS group had significantly lower postoperative visual analogue pain score compared to the SWL group (5.2 ± 2.8 versus 3.1 ± 2.7, P < .001). Steinstrasse formation and renal hematoma were observed in 4 and one patient in the SWL group versus no patient in the RIRS group. Postoperative hospital stay was significantly shorter in the SWL group (6.7 ± 1.3 versus18.9 ± 4.3 hours, P < .001). CONCLUSION: The RIRS procedure is a safe treatment option for renal stones of ≤2cm with less pain and higher success rate at first session compared to SWL. .
RCT Entities:
PURPOSE: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (SWL) for stones &le; 2 cm. MATERIALS AND METHODS:Patients who were diagnosed with kidney stones of &le; 2 cm underwent RIRS or SWL in a parallel group randomized clinical trial with balanced randomization [1:1] from 2011 to 2014. The primary outcome of interest was stone free rate after a single session intervention. Patients were evaluated by ultrasonography and KUB at 1 and 3 months after the intervention for the presence of residual stone by a radiologist who was blinded to the study. RESULTS: The stone free rate one month after a single session intervention in the RIRS group was higher than the SWL group (90% versus 75%, P = .03). The success rates after two sessions of RIRS versus SWL were 96.7% versus 88.3% respectively. (P = .08) Patients in the RIRS group had significantly lower postoperative visual analogue pain score compared to the SWL group (5.2 &plusmn; 2.8 versus 3.1 &plusmn; 2.7, P &lt; .001). Steinstrasse formation and renal hematoma were observed in 4 and one patient in the SWL group versus no patient in the RIRS group. Postoperative hospital stay was significantly shorter in the SWL group (6.7 &plusmn; 1.3 versus18.9 &plusmn; 4.3 hours, P &lt; .001). CONCLUSION: The RIRS procedure is a safe treatment option for renal stones of &le;2cm with less pain and higher success rate at first session compared to SWL.&nbsp.
Authors: Doo Yong Chung; Dong Hyuk Kang; Kang Su Cho; Won Sik Jeong; Hae Do Jung; Jong Kyou Kwon; Seon Heui Lee; Joo Yong Lee Journal: PLoS One Date: 2019-02-21 Impact factor: 3.240