Hanan Goldberg1,2,3, Dor Golomb4,5,6, Yariv Shtabholtz4,5,6, Shlomi Tapiero4,5,6, German Creiderman4,5,6, Avi Shariv4,5,6, Jack Baniel4,5,6, David Lifhshitz4,5,6. 1. Minimally Invasive Unit, Department of Urology, Golda Hospital, Rabin Medical Center, Petach Tikva, Israel. Gohanan@gmail.com. 2. Department of Urology, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel. Gohanan@gmail.com. 3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Gohanan@gmail.com. 4. Minimally Invasive Unit, Department of Urology, Golda Hospital, Rabin Medical Center, Petach Tikva, Israel. 5. Department of Urology, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel. 6. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
PURPOSE: To investigate the performance of retrograde intrarenal surgery (RIRS) for the 1-2 cm renal stone size range in comparison to smaller stones. MATERIALS AND METHODS: From a data base of 3000 ureteroscopies between 2004 and 2014, 635 consecutive patients underwent RIRS for renal stones. Patients were divided to three groups according to their renal stone size (<10, 10-15, 15-20 mm). Preoperative, operative, stone free rate (SFR) and follow-up data were analyzed and compared. RESULTS: The SFR for the three groups was 94.1, 90.1 and 85%, respectively. Patients with renal stone size above 15 mm had a statistically significantly lower SFR. The efficiency quotient calculated for stones larger and smaller than 15 mm was 83.9 vs. 91.8%, respectively (p < 0.01). The mean operative time and hospital stay were longer for patients with renal stones larger than 15 mm (73.6 ± 29.9 vs. 53 ± 19.4 min, p < 0.01 and 2.2 ± 2 vs. 1.8 ± 1.8 days, p = 0.031, respectively). Moreover, the complication rate was almost two times higher (10 vs 5.4%, p = 0.08). Concomitant ureteral stones and older age were independent predictors of failure in the large stone group. CONCLUSIONS: While the overall SFR following RIRS for renal stones up to 2 cm is generally high, the SFR for 15-20 mm stones is significantly lower, with a longer operating time and hospital stay, and a higher complication rate.
PURPOSE: To investigate the performance of retrograde intrarenal surgery (RIRS) for the 1-2 cm renal stone size range in comparison to smaller stones. MATERIALS AND METHODS: From a data base of 3000 ureteroscopies between 2004 and 2014, 635 consecutive patients underwent RIRS for renal stones. Patients were divided to three groups according to their renal stone size (<10, 10-15, 15-20 mm). Preoperative, operative, stone free rate (SFR) and follow-up data were analyzed and compared. RESULTS: The SFR for the three groups was 94.1, 90.1 and 85%, respectively. Patients with renal stone size above 15 mm had a statistically significantly lower SFR. The efficiency quotient calculated for stones larger and smaller than 15 mm was 83.9 vs. 91.8%, respectively (p < 0.01). The mean operative time and hospital stay were longer for patients with renal stones larger than 15 mm (73.6 ± 29.9 vs. 53 ± 19.4 min, p < 0.01 and 2.2 ± 2 vs. 1.8 ± 1.8 days, p = 0.031, respectively). Moreover, the complication rate was almost two times higher (10 vs 5.4%, p = 0.08). Concomitant ureteral stones and older age were independent predictors of failure in the large stone group. CONCLUSIONS: While the overall SFR following RIRS for renal stones up to 2 cm is generally high, the SFR for 15-20 mm stones is significantly lower, with a longer operating time and hospital stay, and a higher complication rate.
Entities:
Keywords:
Renal stone; Retrograde intrarenal surgery; Stone free rate; Ureteroscopy
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