Systematic Review and Meta-analysis to Compare Success Rates of Retrograde Intrarenal Surgery Versus Percutaneous Nephrolithotomy for Renal Stones >2 cm: An Update

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2017 Dec 17

PMID 29245347

Citations 21

Authors

Sung Ku Kang

Kang Su Cho

Dong Hyuk Kang

Hae Do Jung

Jong Kyou Kwon

Joo Yong Lee

Affiliations

Soon will be listed here.

Abstract

Background: We performed a systematic review and meta-analysis comparing stone-free rates between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using updated, more reliable evidence.

Materials And Methods: Randomized controlled trials comparing RIRS and PCNL for >2 cm stones were identified from electronic databases. Stone-free rates for the procedures were compared by qualitative and quantitative syntheses (meta-analyses). Outcome variables are shown as risk ratios (RRs) with 95% confidence intervals (CIs).

Results: Eleven articles were included in this study. Most recently published studies exhibited relatively low quality during quality assessment. For the meta-analysis comparing success (stone-free) rates between PCNL and RIRS, the forest plot using the random-effects model showed an RR of 1.11 (95% CI 1.02-1.21, P < .014) favoring PCNL. After determining the among-study heterogeneity, subgroup analysis was performed of 9 studies with less heterogeneity: the stone-free rate of PCNL was superior to that of RIRS using a fixed-effect model (RR 1.07, 95% CI 1.01-1.14, P < .019) for these studies.

Conclusions: RIRS can be a safe and effective procedure for selected patients with large renal stones. However, in this meta-analysis, the postoperative stone-free rate of PCNL was higher than that of RIRS in patients with >2 cm renal stones.

Citing Articles

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In the Treatment of Lower Pole Kidney Stones Between 1-2 cm in Children, Which is the Best Approach? Retrograde Intrarenal Surgery or Mini Percutaneous Nephrolithotomy.

Arikan Y, Dumanli E, Alper Kara Y, Kumcu A, Keskin M, Can Erdogan U Sisli Etfal Hastan Tıp Bul. 2024; 58(3):332-338.

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Comparative Analysis of Surgical Outcomes of Flexible Ureteroscopy and Da Vinci Robotic Surgery in Community Patients with Renal Pelvic Stones Larger than 2 cm.

Yeh Y, Weng S, Lin Y, Chen C, Tsao S, Tsai H Medicina (Kaunas). 2023; 59(8).

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Outcomes in Lower Pole Kidney Stone Management Using Mini-Percutaneous Nephrolithotomy Compared With Retrograde Intra Renal Surgery: A Randomized Controlled Trial.

Rehman O, Imran M, Rafaqat M, Haider F, Rehman A, Farooq U Cureus. 2023; 15(2):e35343.

PMID: 36974241 PMC: 10039418. DOI: 10.7759/cureus.35343.

Influencing factors of acute kidney injury following retrograde intrarenal surgery.

Goger Y, Ozkent M, Kilinc M, Erol E, Taskapu H World J Urol. 2023; 41(3):857-864.

PMID: 36719465 DOI: 10.1007/s00345-023-04301-6.

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