PMID- 22037633
OWN - NLM
STAT- MEDLINE
DCOM- 20120503
LR  - 20220309
IS  - 1433-8726 (Electronic)
IS  - 0724-4983 (Linking)
VI  - 29
IP  - 6
DP  - 2011 Dec
TI  - Flexible ureterorenoscopy versus miniaturized PNL for solitary renal calculi of 
      10-30 mm size.
PG  - 755-9
LID - 10.1007/s00345-011-0784-y [doi]
AB  - INTRODUCTION: The value of flexible ureterorenoscopy (fURS) and miniaturized PNL 
      (mPNL) for larger renal calculi is under discussion. This non-randomized 
      prospective study aimed to evaluate fURS and mPNL for solitary renal stones of 
      10-30 mm size. MATERIALS AND METHODS: fURS was carried out in 21 patients with 
      last generation 7.5F endoscopes. Ureteral access sheaths were used in 19 
      patients. For mPNL, an 18F modified Amplatz sheath with a 14F nephroscope were 
      used (n = 25). The procedure was performed either tubeless with an antegrade 
      stent or a nephrostomy. Outcome and complications of both procedures were 
      assessed. RESULTS: Patients' demographics and stone sizes were comparable (18 +/- 5 
      vs. 19 +/- 4 mm, P = 0.08). Patients in the fURS group had a higher mean BMI (31 
      vs. 27, P < 0.05). Total OR time was significantly longer for fURS (106 +/- 51 vs. 
      59 +/- 19 min., P < 0.001). More patients were stone-free after one single 
      percutaneous treatment, while 2nd-stage treatments with fURS were common (total 
      procedures 1.04 vs. 1.52, P < 0.001; immediate stone-free rate (SFR) 96% vs. 
      71.5%, P < 0.001). SFR after 4 weeks was 100% (mPNL) and 85.8% (fURS) (P < 0.01). 
      Minor complications as classified by Clavien I or II occurred in 16 and 23.8%, 
      mPNL and fURS, respectively, P = 0.13). No major complications (Clavien III-V) 
      occured in both groups. CONCLUSIONS: Our series supports both the concept of 
      either percutaneous or retrograde endoscopic treatment for renal calculi with 
      both modalities offering excellent safety. However, while for fURS, a 
      significantly higher rate of 2nd-stage procedures was necessary, and mPNL led to 
      faster and higher SFR without increasing complication rate.
FAU - Knoll, Thomas
AU  - Knoll T
AD  - Department of Urology, Klinikum Sindelfingen-Boeblingen Medical Center, 
      University of Tubingen, Arthur-Gruber-Str. 70, 71065, Sindelfingen, Germany. 
      t.knoll@klinikverbund-suedwest.de
FAU - Jessen, Jan Peter
AU  - Jessen JP
FAU - Honeck, Patrick
AU  - Honeck P
FAU - Wendt-Nordahl, Gunnar
AU  - Wendt-Nordahl G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20111029
PL  - Germany
TA  - World J Urol
JT  - World journal of urology
JID - 8307716
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Kidney Calculi/*pathology/*surgery
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Nephrostomy, Percutaneous/adverse effects/*instrumentation/*methods
MH  - Postoperative Complications/epidemiology
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Stents
MH  - Treatment Outcome
MH  - Ureteroscopy/adverse effects/*instrumentation/*methods
EDAT- 2011/11/01 06:00
MHDA- 2012/05/04 06:00
CRDT- 2011/11/01 06:00
PHST- 2011/07/11 00:00 [received]
PHST- 2011/10/06 00:00 [accepted]
PHST- 2011/11/01 06:00 [entrez]
PHST- 2011/11/01 06:00 [pubmed]
PHST- 2012/05/04 06:00 [medline]
AID - 10.1007/s00345-011-0784-y [doi]
PST - ppublish
SO  - World J Urol. 2011 Dec;29(6):755-9. doi: 10.1007/s00345-011-0784-y. Epub 2011 Oct 
      29.