Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis

Abstract Percutaneous nephrostomy (PCNL) and retrograde intrarenal surgery (RIRS) are the two main treatments for upper urinary tract stones. The aim of our study was to compare the effectiveness and safety of standard PCNL (S-PCNL) and RIRS for the treatment of stones at ureteropelvic junction with...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Fang Wang, Yun Hong, Zesong Yang, Liefu Ye
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ddc9fddb03fd466aa519de197bbbd608
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ddc9fddb03fd466aa519de197bbbd608
record_format	dspace
spelling	oai:doaj.org-article:ddc9fddb03fd466aa519de197bbbd6082021-12-02T16:14:47ZComparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis10.1038/s41598-021-93551-82045-2322https://doaj.org/article/ddc9fddb03fd466aa519de197bbbd6082021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93551-8https://doaj.org/toc/2045-2322Abstract Percutaneous nephrostomy (PCNL) and retrograde intrarenal surgery (RIRS) are the two main treatments for upper urinary tract stones. The aim of our study was to compare the effectiveness and safety of standard PCNL (S-PCNL) and RIRS for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. The study included 118 patients who underwent surgery for stones at ureteropelvic junction. S-PCNL and RIRS were performed on 66 and 52 patients, respectively. Patient age, sex, body mass index (BMI), stone side, history of urinary tract infection (UTI), history of diabetes, history of ESWL, stone size, Hounsfield unit (HU) values of stones, grade of hydronephrosis, operating time, postoperative hemoglobin loss, narcotic analgesic use, postoperative transfusion rates, stone-free rates (SFRs), length of hospital stay, complication rates and number of secondary interventions were recorded. The comparison of the operative data between the two groups revealed no statistically significant differences in the operative time, SFRs, narcotic analgesic use, postoperative transfusion rate or other postoperative complications defined according to the Clavien system (P > 0.05). The postoperative urinary sepsis rate in the RIRS group was as high as 15.4%, which was much higher than the 1.5% rate observed in the S-PCNL group, and the difference was statistically significant (P < 0.05). A total of 13.5% of the patients in the RIRS group required a second operation due to failure of the placement of the ureteral access sheath. Additionally, S-PCNL had an advantage in operation time, while RIRS in duration of hospital stay and postoperative hemoglobin loss. RIRS and S-PCNL were safe and effective methods for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. Importantly, S-PCNL had more advantages in terms of the postoperative urinary sepsis rate and secondary surgery rate.Fang WangYun HongZesong YangLiefu YeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fang Wang Yun Hong Zesong Yang Liefu Ye Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
description	Abstract Percutaneous nephrostomy (PCNL) and retrograde intrarenal surgery (RIRS) are the two main treatments for upper urinary tract stones. The aim of our study was to compare the effectiveness and safety of standard PCNL (S-PCNL) and RIRS for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. The study included 118 patients who underwent surgery for stones at ureteropelvic junction. S-PCNL and RIRS were performed on 66 and 52 patients, respectively. Patient age, sex, body mass index (BMI), stone side, history of urinary tract infection (UTI), history of diabetes, history of ESWL, stone size, Hounsfield unit (HU) values of stones, grade of hydronephrosis, operating time, postoperative hemoglobin loss, narcotic analgesic use, postoperative transfusion rates, stone-free rates (SFRs), length of hospital stay, complication rates and number of secondary interventions were recorded. The comparison of the operative data between the two groups revealed no statistically significant differences in the operative time, SFRs, narcotic analgesic use, postoperative transfusion rate or other postoperative complications defined according to the Clavien system (P > 0.05). The postoperative urinary sepsis rate in the RIRS group was as high as 15.4%, which was much higher than the 1.5% rate observed in the S-PCNL group, and the difference was statistically significant (P < 0.05). A total of 13.5% of the patients in the RIRS group required a second operation due to failure of the placement of the ureteral access sheath. Additionally, S-PCNL had an advantage in operation time, while RIRS in duration of hospital stay and postoperative hemoglobin loss. RIRS and S-PCNL were safe and effective methods for the treatment of stones at ureteropelvic junction with high-grade hydronephrosis. Importantly, S-PCNL had more advantages in terms of the postoperative urinary sepsis rate and secondary surgery rate.
format	article
author	Fang Wang Yun Hong Zesong Yang Liefu Ye
author_facet	Fang Wang Yun Hong Zesong Yang Liefu Ye
author_sort	Fang Wang
title	Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
title_short	Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
title_full	Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
title_fullStr	Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
title_full_unstemmed	Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
title_sort	comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ddc9fddb03fd466aa519de197bbbd608
work_keys_str_mv	AT fangwang comparisonofretrogradeintrarenalsurgeryandstandardpercutaneousnephrolithotomyformanagementofstonesatureteropelvicjunctionwithhighgradehydronephrosis AT yunhong comparisonofretrogradeintrarenalsurgeryandstandardpercutaneousnephrolithotomyformanagementofstonesatureteropelvicjunctionwithhighgradehydronephrosis AT zesongyang comparisonofretrogradeintrarenalsurgeryandstandardpercutaneousnephrolithotomyformanagementofstonesatureteropelvicjunctionwithhighgradehydronephrosis AT liefuye comparisonofretrogradeintrarenalsurgeryandstandardpercutaneousnephrolithotomyformanagementofstonesatureteropelvicjunctionwithhighgradehydronephrosis
_version_	1718384322808905728

Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis

Ejemplares similares