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Randomized Controlled Trial
. 2022 Oct;40(10):2555-2560.
doi: 10.1007/s00345-022-04133-w. Epub 2022 Aug 27.

A comparison among RIRS and MiniPerc for renal stones between 10 and 20 mm using thulium fiber laser (Fiber Dust): a randomized controlled trial

Davide Perri  1 , Lorenzo Berti  2 , Andrea Pacchetti  3 , Elena Morini  3 , Matteo Maltagliati  2 , Umberto Besana  3 , Antonio Luigi Pastore  4 , Javier Romero-Otero  5 , Giovanni Saredi  2 , Danilo Centrella  6 , Maria Chiara Sighinolfi  7 , Bernardo Rocco  7 , Salvatore Micali  8 , Paolo Broggini  9 , Marco Boldini  9 , Federica Mazzoleni  3 , Giorgio Bozzini  3
Affiliations
Randomized Controlled Trial

A comparison among RIRS and MiniPerc for renal stones between 10 and 20 mm using thulium fiber laser (Fiber Dust): a randomized controlled trial

Davide Perri et al. World J Urol. 2022 Oct.

Abstract

Purpose: We performed a prospective randomized comparison among Retrograde IntraRenal Surgery (RIRS) and MiniPerc (MP) for stones between 10 and 20 mm to evaluate outcomes with the same laser device: Fiber Dust.

Methods: Patients with a single renal stone between 10 and 20 mm were randomized to RIRS (Group A) versus MP (Group B). Exclusion criteria were age < 18 or > 75, presence of acute infection, coagulation impairments, cardiovascular or pulmonary comorbidities. In both groups, the Fiber Dust laser was used. A CT scan after 3 months was performed. A negative CT scan or asymptomatic patients with stone fragments < 3 mm and a negative urinary culture were the criteria to assess the stone-free status. A statistical analysis was carried out to assess success, complication and retreatment rates and need for auxiliary treatments.

Results: Between January 2021 and January 2022, 186 patients were enrolled (90 in Group A and 96 in Group B). Mean stone size was 15.8 mm and 14.9 mm in Group A and B, respectively (p = 0.23). The overall stone-free rate (SFR) was 73.3% for Group A and 84.4% for Group B. A higher SFR was reached for upper calyceal stones in Group A (90.4%) lower calyceal stones in Group B (91.6%). Retreatment rate (p = 0.31) and auxiliary procedure rate (p = 0.18) were comparable. Complication rate was 5.5% and 5.2% for Groups A and B, respectively.

Conclusions: RIRS and MP are both effective to obtain a postoperative SFR with Fiber Dust. According to the stone position one treatment is superior to the other one.

Keywords: Percutaneous nephrolithotomy; RIRS; Renal stone; Stone-free rate; Thulium fiber laser.

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