.: ORİJİNAL ARAŞTIRMA
Comparison of Retrograde Intrarenal Surgery and Shock Wave Lithotripsy in the Treatment of 10-20 mm Lower Calyceal Stones: Retrospective Clinical Study
10-20 mm Alt Kaliks Taşlarının Tedavisinde Retrograd İntrarenal Cerrahi ve Şok Dalga Litotripsinin Karşılaştırılması: Retrospektif Klinik Çalışma
J Reconstr Urol. 2021;11(3):97-102
doi: 10.5336/urology.2021-83012
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: In our study, we aimed to compare the results of retrograde intrarenal surgery (RIRS), and shock wave lithotripsy (SWL) in the treatment of 10-20 mm lower calyceal stones. Material and Methods: The data of 42 patients who underwent RIRS or SWL for 10-20 mm solitary lower calyceal stones in Erzurum Regional Training and Research Hospital Urology Clinic between January 2018 and September 2019 were retrospectively analyzed. Twenty patients were treated with RIRS and 22 patients were treated with SWL. Both groups were compared in terms of demographic characteristics, clinical data, operative parameters, stone-free rate (SFR), need for retreatment and auxiliary therapy, and complications. Results: Both groups were statistically comparable in terms of their demographic characteristics and stone characteristics. Postoperative SFR was 85% in the RIRS group and 77% in the SWL group. When compared in terms of the procedure time, the mean duration of RIRS was significantly longer when compared with the mean of one-session SWL duration (p<0.001). When compared with the RIRS group, 63.6% of the patients in the SWL group had a significant higher need for re-treatment, because they required a second session (p<0.001). Rates of auxiliary procedures applied were 22.7% in the SWL group and 15% in the RIRS group (p=0.15). The overall complication rates were 10% and 9.1% in the RIRS and SWL groups, respectively. Conclusion: RIRS and SWL are the preferred treatment methods in the treatment of 10-20 mm lower calyceal stones with similar SFR and complication rates.
Keywords: Kidney stone; lower calyx; retrograde intrarenal surgery; shock wave lithotripsy
Objective: In our study, we aimed to compare the results of retrograde intrarenal surgery (RIRS), and shock wave lithotripsy (SWL) in the treatment of 10-20 mm lower calyceal stones. Material and Methods: The data of 42 patients who underwent RIRS or SWL for 10-20 mm solitary lower calyceal stones in Erzurum Regional Training and Research Hospital Urology Clinic between January 2018 and September 2019 were retrospectively analyzed. Twenty patients were treated with RIRS and 22 patients were treated with SWL. Both groups were compared in terms of demographic characteristics, clinical data, operative parameters, stone-free rate (SFR), need for retreatment and auxiliary therapy, and complications. Results: Both groups were statistically comparable in terms of their demographic characteristics and stone characteristics. Postoperative SFR was 85% in the RIRS group and 77% in the SWL group. When compared in terms of the procedure time, the mean duration of RIRS was significantly longer when compared with the mean of one-session SWL duration (p<0.001). When compared with the RIRS group, 63.6% of the patients in the SWL group had a significant higher need for re-treatment, because they required a second session (p<0.001). Rates of auxiliary procedures applied were 22.7% in the SWL group and 15% in the RIRS group (p=0.15). The overall complication rates were 10% and 9.1% in the RIRS and SWL groups, respectively. Conclusion: RIRS and SWL are the preferred treatment methods in the treatment of 10-20 mm lower calyceal stones with similar SFR and complication rates.
Keywords: Kidney stone; lower calyx; retrograde intrarenal surgery; shock wave lithotripsy
ÖZET
Amaç: Çalışmamızda, 10-20 mm alt kaliks taşlarının tedavisinde retrograt intrarenal cerrahi [retrograde intrarenal surgery (RIRS)] ve şok dalgası litotripsi [shock wave lithotripsy (SWL)] sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Ocak 2018-Eylül 2019 tarihleri arasında Erzurum Bölge Eğitim ve Araştırma Hastanesi Uroloji Kliniğinde, 10-20 mm boyutlarında soliter alt kaliks taşı nedeniyle RIRS veya SWL tedavisi uygulanan 42 hastanın verileri retrospektif olarak incelendi. Hastaların 20'sine RIRS, 22'sine ise SWL tedavisi uygulandı. İki grup; demografik özellikler, klinik veriler, operatif parametreler, taşsızlık oranı [stone-free rate (SFR)], yeniden ve yardımcı tedavi uygulanma ihtiyacı ve komplikasyonlar açısından karşılaştırıldı. Bulgular: Demografik karakteristikler ve taş özellikleri açısından her iki grup istatistiksel açıdan benzerdi. Postoperatif SFR, RIRS grubunda %85, SWL grubunda %77 olarak belirlendi. İşlem süresi açısından karşılaştırıldığında RIRS'nin, 1 seans SWL süresine göre anlamlı derecede yüksek olduğu izlendi (p<0,001). SWL grubunda hastaların %63,6'sında 2. seans gerekmesi nedeniyle yeniden tedavi ihtiyacı, RIRS'ye göre anlamlı daha yüksek izlendi (p<0,001). Yardımcı prosedür uygulanma oranı SWL'de %22,7; RIRS grubunda %15 olarak saptandı (p=0,15). Genel komplikasyon oranı, RIRS ve SWL grubunda sırasıyla %10 ve %9,1 olarak izlendi. Sonuç: RIRS ve SWL, benzer SFR ve komplikasyon oranı ile 10-20 mm alt kaliks taşlarının tedavisinde tercih edilebilir tedavi yöntemleridir.
Anahtar Kelimeler: Böbrek taşı; alt kaliks; retrograt intrarenal cerrahi; şok dalgası litotripsi
Amaç: Çalışmamızda, 10-20 mm alt kaliks taşlarının tedavisinde retrograt intrarenal cerrahi [retrograde intrarenal surgery (RIRS)] ve şok dalgası litotripsi [shock wave lithotripsy (SWL)] sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Ocak 2018-Eylül 2019 tarihleri arasında Erzurum Bölge Eğitim ve Araştırma Hastanesi Uroloji Kliniğinde, 10-20 mm boyutlarında soliter alt kaliks taşı nedeniyle RIRS veya SWL tedavisi uygulanan 42 hastanın verileri retrospektif olarak incelendi. Hastaların 20'sine RIRS, 22'sine ise SWL tedavisi uygulandı. İki grup; demografik özellikler, klinik veriler, operatif parametreler, taşsızlık oranı [stone-free rate (SFR)], yeniden ve yardımcı tedavi uygulanma ihtiyacı ve komplikasyonlar açısından karşılaştırıldı. Bulgular: Demografik karakteristikler ve taş özellikleri açısından her iki grup istatistiksel açıdan benzerdi. Postoperatif SFR, RIRS grubunda %85, SWL grubunda %77 olarak belirlendi. İşlem süresi açısından karşılaştırıldığında RIRS'nin, 1 seans SWL süresine göre anlamlı derecede yüksek olduğu izlendi (p<0,001). SWL grubunda hastaların %63,6'sında 2. seans gerekmesi nedeniyle yeniden tedavi ihtiyacı, RIRS'ye göre anlamlı daha yüksek izlendi (p<0,001). Yardımcı prosedür uygulanma oranı SWL'de %22,7; RIRS grubunda %15 olarak saptandı (p=0,15). Genel komplikasyon oranı, RIRS ve SWL grubunda sırasıyla %10 ve %9,1 olarak izlendi. Sonuç: RIRS ve SWL, benzer SFR ve komplikasyon oranı ile 10-20 mm alt kaliks taşlarının tedavisinde tercih edilebilir tedavi yöntemleridir.
Anahtar Kelimeler: Böbrek taşı; alt kaliks; retrograt intrarenal cerrahi; şok dalgası litotripsi
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