title: Mini-percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Renal Stones Larger Than 10 mm: A Prospective Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) in the management of renal stones >10 mm in a single session.
  
  
  METHODS
  Seventy patients presenting with renal stones >10 mm were randomized to a mini-PCNL or an RIRS group in a ratio of 1:1. Randomization was performed by a biostatistician and opened to the surgeon at the time of the patient's admission on the day before surgery. Patient and stone characteristics, perioperative outcomes, and complications were compared between the 2 groups. The primary end point of "stone-free" which was defined as no residual stone or stones <2 mm on computed tomography within 3 months postoperatively.
  
  
  RESULTS
  Thirty-five patients (mini-PCNL) and 33 (RIRS) were included in the final analysis. Mini-PCNL and RIRS had a stone-free rate of 85.7% and 97.0%, respectively (P = .199). Operation time (P = .148), hemoglobin decline (P = .323), and hospital stay (P = .728) were similar between the 2 groups. Pain visual analog score at 1 hour postoperatively (P = .029) and analgesic requirement (P = .050) were higher in the RIRS group. Two patients in the mini-PCNL group and 1 in the RIRS group had minor pelvic or ureter perforation. One patient in each of the 2 groups had hypertension and urinary tract infection.
  
  
  CONCLUSIONS
  Mini-PCNL and RIRS are safe and feasible surgical options to manage renal stones >10 mm. RIRS produced a slightly higher stone-free rate, but more immediate postoperative pain and higher analgesic requirement compared with mini-PCNL.
authors: Department of Urology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors: Jeong Woo
authors: JW
authors: Lee
authors: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors: Juhyun
authors: J
authors: Park
authors: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors: Seung Bae
authors: SB
authors: Lee
authors: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors: Hwancheol
authors: H
authors: Son
authors: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kmoretry@daum.net.
authors: Sung Yong
authors: SY
authors: Cho
authors: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. Electronic address: drjh@brm.co.kr.
authors: Hyeon
authors: H
authors: Jeong
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D010149:Postoperative Pain / Q000503:physiopathology*; D061214:Patient Safety; D011446:Prospective Studies; D020127:Recovery of Function; D012187:Retroperitoneal Space / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler