title: Comparison of miniaturized percutaneous nephrolithotomy and flexible ureterorenoscopy for the management of 10-20 mm renal stones in obese patients.
abstract: OBJECTIVE
  To evaluate and compare effectivity and safety of flexible ureteroscopy (F-URS) and mini-percutaneous nephrolithotomy (mPNL) for 10-20 mm renal stones in obese patients.
  
  
  METHODS
  Between 2012 and 2015, charts of patients who were treated with F-URS or mPNL for 10-20 mm kidney stone(s) were analyzed. Patients with BMI > 30 kg/m(2) were enrolled into the study. Total of 315 patients were treated with mPNL, and 56 patients were matched our inclusion criteria. In the same period, F-URS was performed in 669 patients, and 157 of them had 10-20 mm kidney stones, and their BMI values were >30 kg/m(2). The patients were retrospectively matched at a 1:1 ratio to index F-URS-mPNL cases with respect to the patient age, gender, ASA score, BMI and size, number, and location of stone.
  
  
  RESULTS
  Gender, age, BMI, stone size, stone number, location of stone(s), and ASA scores were similar between groups. The mean operation time was significantly longer in mPNL group (p: 0.021). However, the mean fluoroscopy time was similar (p: 0.270). Hemoglobin drop requiring blood transfusion and angioembolization was performed in two and one patients after mPNL, respectively. Overall complication rate was significantly higher in mPNL group than F-URS group (30.3 vs. 5.3 %, p: 0.001).
  
  
  CONCLUSIONS
  Our results demonstrated that both F-URS and mPNL achieve acceptable stone-free rates in obese patients with 10-20 mm renal stones. However, complication rates were significantly lower in F-URS group.
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey. md.farukozgor@yahoo.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.affiliation: Department of Urology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Tepeler
authors.affiliation: Department of Urology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Elbir
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Sarilar
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Zafer Gokhan
authors.initials: ZG
authors.lastname: Gurbuz
authors.affiliation: Department of Urology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Armagan
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, Millet Cad. No: 11, Fatih, 34096, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
authors.affiliation: Department of Urology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey.
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Tasci
mesh_terms: D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D020709:Ureteroscopes; D018666:Ureteroscopy
keywords: MiniPNL; Obesity; Percutaneous nephrolithotomy; f-URS