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Randomized Controlled Trial
. 2022 Feb;40(2):513-518.
doi: 10.1007/s00345-021-03872-6. Epub 2021 Nov 12.

Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients

Xiao Liu #  1 , Ding Xia #  1 , Ejun Peng  1 , Yonghua Tong  1 , Hailang Liu  1 , Xinguang Wang  1 , Yu He  1 , Zhiqiang Chen  2 , Kun Tang  3
Affiliations
Randomized Controlled Trial

Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients

Xiao Liu et al. World J Urol. 2022 Feb.

Abstract

Objective: To compare the outcomes of mini percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) for the management of 2-3 cm lower pole renal calculi (LPC) in obese patients.

Patients and methods: 120 obese patients with 2-3 cm LPC were randomly divided into mPNL group and RIRS group. Demography, clinical characteristics, perioperative complications, and stone free rate (SFR) were recorded. Stone-free status means no stone on computed tomography 3 months after surgery, or residual fragments were less than 3 mm.

Results: Baseline characteristics were similar between the two groups. The mean stone burden was 585.39 ± 131.06 mm2 in the mPNL group and 548.64 ± 123.55 mm2 in the RIRS group (P = 0.125). The SFR of mPNL group was significantly better than that of RIRS group (86.2% vs 61.4%, P = 0.002). Besides, the overall complication rate was 22.4% in the mPNL group and 7% in the RIRS group (P = 0.02). Patients performed with mPNL required longer length of hospital stay than those with RIRS (P = 0.001). There were no significant differences in operative time and stone composition between the two groups.

Conclusion: In our study, both mPNL and RIRS are safe and effective techniques for the treatment of 2-3 cm LPC in obese patients. Compared to RIRS, mPNL has better SFR at the expense of the higher incidence of complications and prolonged length of hospital stay.

Keywords: Lower pole renal calculi; Mini percutaneous nephrolithotomy; Obesity; Randomized control trial; Retrograde intrarenal surgery.

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