COMPARISON BETWEEN RETROGRADE INTRARENAL SURGERY (RIRS) AND PERCUTANEOUS NEPHROLITHOTOMY (PCNL) IN THE TREATMENT OF SINGLE RENAL STONE 2-3CM

CORRESPONDING AUTHOR:
Dr. Deepak Garg,
Senior Resident,
Department of Urology,
Amrita Institute of Medical Sciences,
Ponnekara, Kochi, India.
E-mail: drdeepakgarg@gmail.com

ABSTRACT: CONTEXT: Open surgery has given way to endoscopic surgeries. PCNL makes its way puncturing renal parenchyma where there is an unknown factor of damaging a major blood vessel. This may be overcome by retrograde intrarenal surgeries (RIRS) but the instrument has to traverse a long way through natural orifice and lumen. Which is less harmful and more helpful. AIM: To compare results from RIRS and PCNL in treating renal calculi of 2 to 3cm. MATERIALS AND METHODS: Retrospective analysis of consecutive patients who underwent PCNL or RIRS for stones with 20–30mm diameter, in a single institution between January 2008 and December 2014. RESULTS: Mean operative time for PCNL is significantly less as compared to RIRS (p=0.001). Hemoglobin drop was significantly high in PCNL group 1.2gm%. Stone clearance rate was much higher in PCNL group with 95.7% of the patients requiring only single procedure. CONCLUSION: PCNL is more effective than RIRS for stones between 2–3cm at a cost of longer hospital stay, increased blood loss, increased need for transfustions.

KEYWORDS: Percutaneous nephrolithotomy, retrograde intrarenal surgery, minimal invasive, flexible ureterorenoscopy.