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Chinese Journal of Endourology(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (03): 233-236. doi: 10.3877/cma.j.issn.1674-3253.2023.03.007

• Clinical Research • Previous Articles     Next Articles

Comparison of retrograde intrarenal surgery and percutaneous nephroscopy in the treatment of complex renal calculi with a history of previous percutaneous nephroscopy

Junchao Wu1, Shuchen He1, Haifeng Wang1, Jiaping Wang1, Xuede Qiu1,()   

  1. 1. Department of Urology, the Second Affiliated Hospital of Kunming Medical University, Yunnan 650032, China
  • Received:2023-01-10 Online:2023-06-01 Published:2023-05-23
  • Contact: Xuede Qiu

Abstract:

Objective

To investigate the safety and efficacy of secondary surgery with percutaneous nephrolithotripsy (PCNL) or retrograde intrarenal surgery (RIRS) for the treatment of complex kidney stones of patients with a history of PCNL.

Methods

The clinical data of 76 patients with PCNL and 83 patients with RIRS patients who had a history of PCNL admitted to the Second Affiliated Hospital of Kunming Medical University from January 2017 to May 2022 were retrospectively analyzed. The differences in intraoperative blood loss, preoperative urinary tract infection, stone clearance rate, surgical time, hospitalization time, hospitalization cost, and postoperative complications between the two groups were compared.

Results

The results showed that there was no statistically significant difference in age, gender, body mass index, maximum diameter of stones, and urinary tract infection rate between the PCNL and RIRS group (P>0.05). The intraoperative blood loss was (23±11) g/L in the PCNL group and (16±7) g/L in the RIRS group, the intraoperative loss of hematocrit was (6.4±3.0)% and (4.5±2.1)%, the surgical time was (155±39) minutes and (118±33) minutes, the stone clearance was achieved in 49 cases (64.5%) and 66 cases (79.5%), the average hospital stay was (7.0±2.2) days and (5.6±1.5) days, and the treatment cost was (13 978±3 487) yuan and (19 783±7239) yuan, respectively, all of which were statistically significant (P<0.05). There was no statistically significant difference in postoperative complications between the two groups (P>0.05).

Conclusions

For patients with complex kidney stones who have a history of PCNL, secondary surgery with RIRS is more effective than PCNL, but the treatment cost is higher than PCNL. Both treatment methods are safe and effective.

Key words: PCNL, RIRS, Secondary surgery, Residual stone

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