Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones.
OBJECTIVE
In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery.


METHODS
Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded.


RESULTS
The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm(2) in the PNL, 1.4±0.1 cm(2) in the RIRS, and 3.1±0.9 cm(2) in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups.


CONCLUSIONS
PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Hüseyin
H
Aydemir
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Salih
S
Budak
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Şükrü
Ş
Kumsar
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Osman
O
Köse
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Hasan Salih
HS
Sağlam
Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Öztuğ
Ö
Adsan
Kidney stones; open surgery; percutaneous nephrolithotomy; retrograde intrarenal surgery