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Vol. 41. Issue 3.
Pages 194-199 (April 2017)
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Vol. 41. Issue 3.
Pages 194-199 (April 2017)
Original article
Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2–3cm
Análisis comparativo entre nefrolitotomía percutánea y ureteroscopia flexible en litiasis renal de 2–3cm
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E. Pieras, V. Tubau, X. Brugarolas, J. Ferrutxe, P. Pizá
Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, Spain
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Tables (4)
Table 1. Comparative summary table of patient clinical data and renal lithiasis data.
Table 2. Comparative summary table of the results obtained.
Table 3. Ratio of analysis of calculi in relation to the surgical technique performed.
Table 4. Summary of the publications referenced in the bibliography.
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Abstract
Introduction

To compare percutaneous nephrolithotomy and flexible ureterorenoscopy for treating kidney stones between 2 and 3cm.

Material and methods

A prospective, comparative, nonrandomised study was conducted with 108 patients with kidney stones between 2 and 3cm. Fifty-four patients underwent percutaneous nephrolithotomy and 54 underwent flexible ureteroscopy. We compared the following variables: lithiasis-free rate (%), surgical time, the need for an auxiliary process, postoperative complications, hospital stay, readmission rates and recovery time.

Results

There were no differences in the lithiasis-free rate between the 2 surgical techniques (76% for ureteroscopy vs. 87% for nephrolithotomy; p=0.1) or in the complications (29% for nephrolithotomy vs. 27% for ureteroscopy; p=0.4). A larger number of auxiliary process were needed for the ureteroscopy group (20%) than for the nephrolithotomy group (7%) (p=0.04).

The surgical time was longer for the nephrolithotomy group (121±52min) than for the ureteroscopy group (93±42min) (p=0.004).

The ureteroscopy group had shorter hospital stays (2.1±1.6 vs. 3.9±1.9 days; p=0.002), shorter convalescence (8.1±4.9 vs. 13.3±4.2 days; p=0.005) and higher readmission rates (7.4% vs. 0%, p=0.05) than the nephrolithotomy group.

Conclusions

Nephrolithotomy and ureteroscopy have similar efficacy for treating kidney stones measuring 2–3cm, with no differences in complications.

Ureteroscopy results in shorter hospital stays, quicker recoveries but more readmissions and a greater need for auxiliary procedures.

Keywords:
Percutaneous nephrolithotomy
Flexible ureteroscopy
2–3cm kidney stones
Resumen
Introducción

Comparar la nefrolitotomía percutánea y la ureterorrenoscopia flexible para el tratamiento de la litiasis renal entre 2 y 3cm.

Material y métodos

Estudio prospectivo, comparativo, no aleatorizado en 108 pacientes con litiasis renal entre 2 y 3cm; a 54 se les realizó nefrolitotomía percutánea y a 54 una ureteroscopia flexible. Las variables comparadas son: tasa libre de litiasis (%), tiempo quirúrgico, requerimiento de proceso auxiliar, complicaciones postoperatorias, estancia hospitalaria, tasas de reingreso y tiempo de recuperación.

Resultados

No existieron diferencias en la tasa libre de litiasis entre ambas técnicas quirúrgicas (76% ureteroscopia, 87% nefrolitotomía) (p=0,1), ni en las complicaciones (nefrolitotomía: 29%; ureteroscopia: 27%; p=0,4). Se ha requerido mayor número de procesos auxiliares en el grupo de ureteroscopia (20%) frente al de nefrolitotomía (7%) (p=0,04).

El tiempo quirúrgico fue más largo en el grupo de nefrolitotomía (121±52min) que en el grupo de ureteroscopia (93±42min) (p=0,004).

El grupo de ureteroscopia tuvo menor estancia hospitalaria (2,1±1,6 vs. 3,9±1,9 días, p=0,002), menor convalecencia (8,1±4,9 vs. 13,3±4,2 días, p=0,005) y mayores tasas de reingreso (7,4% vs. 0%, p=0,05) que el grupo de nefrolitotomía.

Conclusiones

La nefrolitotomía y la ureteroscopia tienen una eficacia similar para el tratamiento de la litiasis renal entre 2–3cm, sin diferencias en las complicaciones.

La ureteroscopia tiene menor estancia hospitalaria, una recuperación más rápida pero mayor reingreso y necesidad de procedimiento auxiliar.

Palabras clave:
Nefrolitotomía percutánea
Ureteroscopia flexible
Litiasis renal 2–3cm

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