Comparison of Retrograde Intrarenal Surgery, Mini Percutaneous and Super Mini Percutaneous in the Treatment of <2cm Renal Lower Pole Stones

Abstract

Renal lower pole stones are a common disorder in the community. In this study, we aimed to compare Retrograde intrarenal surgery (RIRS), Mini PCNL(percutaneous nephrolithotomy) and Super Mini PCNL treatments in the treatment of lower pole stones. Patients who had lower pol renal stones with <20 mm stone sizes were en-rolled in the study. Preoperatively, renal stone and kidney characteristics were evaluated renal ultrasonography, intravenous pyelography and/or non-contrast abdominal computed tomography (CT). RIRS, Mini PCNL and Super Mini PCNL surgery methods were performed. Holmium laser and pneumatic lithotriptor were used for stone lithotripsy. The mean age of the patients in the RIRS group was 35 ± 5.23 years, the mean age in the Mini PCNL group was 38.3 ± 6.47 years and the mean age in the Super Mini PCNL group was 34.12 ± 3.56 years. RIRS were performed in 43 patients, Mini PCNL 37 patients and Supper Mini PCNL 35 patients.Stone free in RIRS was 74.3% Mini PCNL was 93.3% Super Mini PCNL was 94.6 %. According to clavien dindo classification postop grade2-3 complication , in RIRS was 4,6%Mini PCNL was 8,1% .But no grade2-3 complication was seen in Super Mini PCNL group. Hospital stay of RIRS was 1.59± 2.03 mini pnl was 3.73±1.76 and Super Mini PCNL was 2.3±1.55.Cost analysis respectively ,RIRS group, $801.52 ± 25.32; Mini PCNL group, $698.33 ± 22.37; Super Mini PCNL group,$703.13±62. In lower pole stones, RIRS is minimally invasive and have less hospital stay.Stone free rates were higher in Mini PCNL and Super Mini PCNL than RIRS. Super Mini PCNL has short hospital stay and less postoperative complication rate than Mini PCNL. RIRS is more expensive than Mini PCNL and SMP.