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Safety and efficacy of Percutaneous Nephrolithotomy (PCNL) vs Retrograde Intrarenal Surgery (RIRS) in the management of stones located in horseshoe kidneys: A critical comparative evaluation

By: Eryildirim B.1, Kucuk E.V.2, Ozturk M.3, Senkul T.4, Tuncer M.1, Tahra A.2, Turan T.5, Ates F.4, Yilmaz O.4, Sabuncu K.1, Sarica K.1
Institutes: 1Dr.Lutfi Kirdar Kartal Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 2Umraniye Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 3Haydarpasa Numune Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 4Sultan Abdulhamid Han Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 5Medeniyet University, Goztepe Training and Research Hospital, Dept. of Urology, Istanbul, Turkey

Introduction & Objectives

To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy (PCNL) vs Retrograde Intrarenal Surgery (RIRS)) in the management of stones in patients with horseshoe kidneys (HSK).

Material & Methods

Departmental files of 88 cases with radiopaque kidney stones in horseshoe kidneys undergoing two different approaches (PCNL vs RIRS) were evaluated with respect to the success and complication rates of in a retrospective manner. In addition to the factors related with the procedures (success and complication rates, additional procedures), patient (age, gender) and stone characteristics (size, number and site) were all well evaluated. Findings obtained in both groups were evaluated in a comparative manner with respect to the statistical significance.

Results

Stone free rates were comparable in both groups after 1 week period (81.6 % PCNL vs 80 % RIRS). As well as 3 months evaluation (84.2 % PCNL and 82.0 % RIRS). The percentage of the cases with residual fragments (> 4 mm) were similar in both groups (5 cases in PCNL, 7 cases in RIRS) and while all PCNL procedures were completed in one session, mean number of RIRS sessions was higher (1.22±0.05). Mean duration of the procedure was slightly higher in RIRS group and based on Clavien scoring system, despite a higher risk of hemoglobin (Hb) drop noted in patients treated with PCNL, all complication rates were found to be similar in both groups.

Conclusions

Our results demonstrate that of the available minimally invasive treatment alternatives, both PCNL and RIRS could be safe and effective alternatives for renal stone removal in patients with HSK.

  • Event: 4th Meeting of the EAU Section of Urolithiasis (EULIS)
  • Type: Abstract
  • Date: 06-10-2017
  • Views: 116
  • Nr: 96
  • Session: PNL
  • Location: Friday 6 October 2017, 14:00 - 15:30, Stolz 1