Abstract
Purpose
To investigate the performance of retrograde intrarenal surgery (RIRS) for the 1–2 cm renal stone size range in comparison to smaller stones.
Materials and methods
From a data base of 3000 ureteroscopies between 2004 and 2014, 635 consecutive patients underwent RIRS for renal stones. Patients were divided to three groups according to their renal stone size (<10, 10–15, 15–20 mm). Preoperative, operative, stone free rate (SFR) and follow-up data were analyzed and compared.
Results
The SFR for the three groups was 94.1, 90.1 and 85%, respectively. Patients with renal stone size above 15 mm had a statistically significantly lower SFR. The efficiency quotient calculated for stones larger and smaller than 15 mm was 83.9 vs. 91.8%, respectively (p < 0.01). The mean operative time and hospital stay were longer for patients with renal stones larger than 15 mm (73.6 ± 29.9 vs. 53 ± 19.4 min, p < 0.01 and 2.2 ± 2 vs. 1.8 ± 1.8 days, p = 0.031, respectively). Moreover, the complication rate was almost two times higher (10 vs 5.4%, p = 0.08). Concomitant ureteral stones and older age were independent predictors of failure in the large stone group.
Conclusions
While the overall SFR following RIRS for renal stones up to 2 cm is generally high, the SFR for 15–20 mm stones is significantly lower, with a longer operating time and hospital stay, and a higher complication rate.
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HG: Project development, Data collection and analysis, Manuscript Writing. DG: Project development, Data collection, Data analysis. YS: Project development, Data collection, Data analysis. ST: Project development, Data collection, Data analysis. GC: Project development, Data collection, Data analysis. AS: Project development, Data collection, Data analysis. JB: Project development, Manuscript editing. DL: Project development, Data analysis, Manuscript editing.
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This was a retrospective chart review study involving human participants only.
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Goldberg, H., Golomb, D., Shtabholtz, Y. et al. The “old” 15 mm renal stone size limit for RIRS remains a clinically significant threshold size. World J Urol 35, 1947–1954 (2017). https://doi.org/10.1007/s00345-017-2075-8
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DOI: https://doi.org/10.1007/s00345-017-2075-8