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Inicio Actas Urológicas Españolas (English Edition) Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal l...
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Vol. 41. Issue 8.
Pages 516-521 (October 2017)
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Vol. 41. Issue 8.
Pages 516-521 (October 2017)
Original article
DOI: 10.1016/j.acuroe.2017.02.015
Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 CM
Cirugía retrógrada intrarrenal y micro-nefrolitectomía percutánea en la litiasis renal menor de 2cm
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M. Cepeda
Corresponding author
marcoscepedadelgado@yahoo.es

Corresponding author.
, J.H. Amón, J.A. Mainez, B. de la Cruz, V. Rodríguez, D. Alonso, J.M. Martínez-Sagarra
Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, Spain
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Tables (3)
Table 1. Demographic variables.
Table 2. Characteristics of the lithiases.
Table 3. Results.
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Abstract
Introduction

Microperc is the upgraded form of percutaneous nephrolithotomy miniaturization. The aim of this study is to compare prospectively microperc and retrograde intrarenal surgery for the treatment of renal stones smaller than 2cm.

Material and methods

A comparative prospective study of both techniques was carried out between January 2014 and June 2015. Thirty-five patients were divided in two groups: Group A, 17 patients treated by retrograde intrarenal surgery and Group B, 18 patients treated by microperc. Stone clearance was assessed using CT scan 3 months after surgery.

Results

Both groups were statistically comparable as demographic variables and stone size was similar (16.76mm Group A vs 15.72mm Group B). Success rate, hospital stay and JJ stenting were similar for both groups. There was no statistically significant difference regarding post-operatory complications: 17.64% Group A vs 5.56% Group B (p=0.062), all of them Clavien I and II. Surgical time was statistically different (63.82min Group A vs 103.24min Group B) as well as hemoglobin drop (0.62g/dl Group A and 1.89g/dl Group B).

Conclusion

Microperc is an effective and safe procedure for the treatment of renal lithiasis smaller than 2cm, which makes it a good alternative to retrograde intrarenal surgery for this stone size. However, more prospective studies that include a larger cohort are necessary to confirm our results.

Keywords:
Micro-percutaneous nephrolithotomy
Microperc
Retrograde intrarenal surgery
Flexible ureteroscopy
Renal lithiasis
Holmium laser
Resumen
Introducción

Microperc es el culmen de la miniaturización de la nefrolitectomía percutánea. El objetivo de nuestro trabajo es comparar prospectivamente microperc y cirugía retrógrada intrarrenal para el tratamiento de la litiasis renal menor de 2cm.

Material y métodos

Realizamos un estudio comparativo prospectivo entre ambas técnicas, entre enero de 2014 a junio 2015, sobre 35 pacientes que fueron divididos en 2 grupos: grupo A, 17 pacientes tratados mediante cirugía retrógrada intrarrenal y grupo B, 18 pacientes tratados mediante microperc. La tasa de éxito se estableció mediante TC a los 3 meses de la intervención.

Resultados

Ambos grupos resultaron estadísticamente comparables gracias a la ausencia de diferencia tanto en variables demográficas como en el tamaño litiásico (16,76mm grupo A y 15,72mm grupo B). La tasa de éxito, la estancia hospitalaria y el tiempo de cateterismo posquirúrgico fueron similares para ambos grupos. Las complicaciones posquirúrgicas no alcanzaron diferencia estadísticamente significativa: 17,64% grupo A y 5,56% grupo B (p=0,062), todas ellas Clavien I y II. El tiempo quirúrgico sí alcanzó diferencia estadísticamente significativa (63,82min grupo A y 103,24min grupo B), así como la caída de hemoglobina (0,62g/dl grupo A y 1,89g/dl grupo B).

Conclusión

Microperc es un procedimiento eficaz y seguro para el tratamiento de la litiasis renal inferior a los 2cm, pudiendo considerarse como alternativa a la cirugía retrógrada intrarrenal en este rango litiásico. Son necesarios más estudios prospectivos con un tamaño muestral mayor para confirmar nuestros resultados.

Palabras clave:
Micro-nefrolitectomía percutánea
Microperc
Cirugía retrógrada intrarrenal
Ureteroscopia flexible
Litiasis renal
Láser holmium

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