Comparison of mini-percutaneous nephrolithotomy and retrograde intrarenal surgery for 1-2 cm renal stones: A single-center experience.

Abstract

Background: The management of renal stones has undergone significant advancements in recent years, with percutaneous nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) emerging as minimally invasive alternatives to traditional Pyelolithotomy. This study aims to assess the effectiveness of Mini-PCNL and RIRS for renal stones measuring 1-2 cm, focusing on operative time, stone clearance, hospital stay, and the need for ancillary procedures.

Methodology: This retrospective study collected data from the medical records of patients admitted to The Department of Urology at The Kidney Centre, Karachi, between January 1, 2021, and August 31, 2022. The study included 100 patients who underwent RIRS and 129 patients who underwent Mini-PCNL.

Results: It was found that the operative time was statistically similar in both groups. However, the length of hospital stay was significantly higher in the Mini-PCNL group (more than 2 days in 88.4%), whereas in the RIRS group, the majority of patients stayed ≤ 2 days (78%). Overall stone clearance was 82.1%, with a slightly higher clearance rate in patients who underwent Mini-PCNL (85.3%) compared to RIRS (78%), though the p-value was not statistically significant.

Conclusion: For renal stones sized 1-2 cm, both RIRS and Mini-PCNL demonstrate efficient treatment options with comparable stone-free rates. RIRS appears more comfortable and less morbid than Mini-PCNL, with a shorter hospital stay. Although Mini-PCNL requires an extended hospital stay to treat 1- to 2-cm renal stones, it is associated with fewer complications and a reduced need for a JJ stent, making it a viable alternative to RIRS in certain cases.