Comparison of percutaneous nephrolithotomy and retrograde intrarenal surgery outcomes for kidney stones larger than 2 cm from Guy's stone scoring system perspective
International Journal of Clinical Practice, cilt.75, sa.12, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 75 Sayı: 12
- Basım Tarihi: 2021
- Doi Numarası: 10.1111/ijcp.14956
- Dergi Adı: International Journal of Clinical Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, International Pharmaceutical Abstracts, MEDLINE
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To compare surgical outcomes of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgeries (RIRS) as a result of kidney stones larger than 2 cm, together with Guy's stone scores (GSS). Materials and Methods: The data of 811 patients with stone sizes 2-6 cm were operated using PNL (n = 361) and RIRS (n = 450) reviewed retrospectively. GSS were graded 1, 2, 3 or 4 according to the computed tomography findings. Stone-free rate (SFR), operation times, length of hospital stay (LOHS) and Clavien complications (CC) were recorded. Results: Although mean operative times were significantly longer in the RIRS group than the PNL group in GSS grades 1, 2 and 3 (P <.001), it was similar between the two groups in GSS grade 4 (P =.186). SFRs in the PNL and RIRS group were 90.3% and 58.4% on post-operative 10th day (P <.001), and it raised up to 95.3% and 81.6% after secondary interventions (P <.001). Significantly higher SFRs observed in the PNL group in GSS grades 1, 2 and 3 categories. On postoperative 10th day, the SFRs were similar in both GSS grade 4 categories (P =.06). LOHS was longer in the PNL group (P <.001). Although LOHS was significantly longer only in GSS grade 3 (P =.043) and GSS grade 4 (P <.001) in the PNL group, it was similar in GSS grade 1 and 2 between groups. Clavien complications increased in line with GSS in the PNL group (P <.001), but the difference did not differ between GSS grade 3 and 4. Conclusion: SF of PNL in a single session and short operation time seems to be significant especially in GSS grades 1, 2 and 3 category stones. Although the number of patients in the GSS 4 group is very small to claim this, RIRS might be considered as an alternative to PNL in a special group of patients such as GSS grade 4 because of its lower complication rates and shorter LOHS.