Mini- Percutaneous Nephrolithotomy (MPCNL) VS. Flexible Ureterorenoscopy (RIRS) for Renal Stones >2cm

A.M.El Shazly, A.A.Taleb, A.S.Ahmed and M.M.Farag"


To evaluate the efficacy and safety of mini percutaneous nephro-lithotripsy (mini PCNL) and retrograde intrarenal surgery (RIRS) in treatment of renal stones larger than 20mm in its longest diameter. Patients & Methods: In a prospective randomized study including 40 patients divided into two groups each 20 patient. Gathering An included 12 guys and 8 females with age went from 15 to 62 years had smaller than expected PCNL for renal pelvic and calyceal stones. Gathering B included 8 guys and 12 females with age extended from 18 to 65 years of age had RIRS. Adaptable ureteroscopy was utilized for pelvic and calyceal stones utilizing holmium:YAG laser (tidying approach). In the two gatherings the strategy result regarding Operative time, Blood misfortune, clinic remain, entanglements utilizing changed Clavien reviewing framework , the need of assistant systems , stone free rates following 3 weeks by utilizing CTUT, were assessed measurably. Measurable investigation of the information indicated that there was immaterial contrast between the {mean ± SD} of the BMI in patients of gathering A which was {27.850±3.183} kg/m2; while in patients of gathering B was {29.700±7.927} kg/m2 . With respect to measure, there was immaterial contrast between the {mean ± SD} of gathering A which was 2.57±0.22mm, while in bunch B was 2.6±0.24mm. With respect to usable time the {mean ± SD} of gathering A was 104.43±14.79 minutes which was altogether (P<0.05) higher contrasted with bunch B 59.71±19.44 minutes. As with respect to emergency clinic stay it was unimportantly (P lower 0.05) higher in bunch A 1.41±0.46 days contrasted with bunch B 1.29±0.44 days. Concerning free rate 89 % of patients rewarded with bunch A were without stone (17 out of 20), while in bunch B 83.4% of patients were sans stone (16 out of 20) following 3 weeks by utilizing CTUT imaging. As to utilizing changed Clavien evaluating correlation with our investigation in which Grade 1: 1 in bunch An and 0 in bunch B , grade 2: 1 in bunch An and 0 in bunch B , grade 3A : 1 in bunch An and 0 in bunch B likewise grade 3B : 0 in bunch An and 0 in bunch B additionally 0 in grade 4 and 5 in the two gatherings In patients with renal stones bigger than 20 mm , results indicated that little PNCL has higher stone free rate and longer employable time than RIRS in cost of higher entanglements rate, blood misfortune, and longer medical clinic remain.

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