TY - JOUR T1 - Comparison between percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of 2 and 3cm renal lithiasis JO - Actas Urológicas Españolas (English Edition) T2 - AU - Fernández Alcalde,Á.A. AU - Ruiz Hernández,M. AU - Gómez dos Santos,V. AU - Sánchez Guerrero,C. AU - Diaz Pérez,D.E. AU - Arias Fúnez,F. AU - Laso García,I. AU - Duque Ruiz,G. AU - Burgos Revilla,F.J. SN - 21735786 M3 - 10.1016/j.acuroe.2019.02.005 DO - 10.1016/j.acuroe.2019.02.005 UR - https://www.elsevier.es/en-revista-actas-urologicas-espanolas-english-392-articulo-comparison-between-percutaneous-nephrolithotomy-flexible-S2173578619300228 AB - Context and objectivesThe first-line treatment for >2cm lithiasis is percutaneous nephrolithotomy (PNL), leaving flexible ureteroscopy (FURS) as a second option. In the present review, the stone-free rate and the complications of both techniques were evaluated in the treatment of 2–3cm stones. Material and methodsSystematic review of studies that compared both techniques. Studies that were not comparative, as well as those carried out in the paediatric population or with <2cm or >3cm stones, were excluded.Two researchers independently performed the investigation, obtaining 5 studies that made up a total of 815 patients: 252 belonged to the FURS group and 563 to the PNL group. Four studies were retrospective, and one was non-randomised prospective. ResultsStone-free rate ranged between 47.0% and 95.0% for the FURS and between 87.0% and 100% for the PNL. The complication rate was 8.8–29.0% in the FURS and 11.9–27.0% in the PNL. FURS required a greater number of procedures, and had a lower decrease in haemoglobin and creatinine rise compared to PNL. ConclusionsThe stone-free rate was higher for PNL, although the FURS could reach comparable results at the expense of performing several procedures. Both techniques have a similar frequency of complications, but the PNL has more postsurgical analytical alterations. ER -