title: Comparison of flexible ureterorenoscopy and mini-percutaneous nephrolithotomy in treatment of lower calyceal stones smaller than 2 cm.
abstract: To compare the outcomes of flexible ureterorenoscopy (F-URS) and mini-percutaneous nephrolithotomy (mini-PNL) in the treatment of lower calyceal stones smaller than 2 cm. Patients who underwent F-URS and mini-PNL for the treatment of lower calyceal stones smaller than 2 cm between March 2009 and December 2014 were retrospectively evaluated. Ninety-four patients were divided into two groups by treatment modality: F-URS (Group 1: 63 patients) and mini-PNL (Group 2: 31 patients). All patients were preoperatively diagnosed with intravenous pyelography or computed tomography. Success rates for F-URS and mini-PNL at postoperative first month were 85.7% and 90.3%, respectively. Operation time, fluoroscopy time, and hospitalization time for F-URS and mini-PNL patients were 44.40 min, 2.9 min, 22.4 h, and 91.9 min, 6.4 min, and 63.8 h, respectively. All three parameters were significantly shorter among the F-URS group (p < 0.001). Postoperative hemoglobin drop was significantly lower in F-URS group compared to mini-PNL group (0.39 mg/dL vs. 1.15 mg/dL, p = 0.001). A comparison of complications according to the Clavien classification demonstrated significant differences between the groups (p = 0.001). More patients in the F-URS groups require antibiotics due to urinary tract infection, and more patients in the mini-PNL group required ureteral double J catheter insertion under general anesthesia. Although both F-URS and mini-PNL have similar success rates for the treatment of lower calyceal stones, F-URS appears to be more favorable due to shorter fluoroscopy and hospitalization times; and lower hemoglobin drops. Multicenter and studies using higher patient volumes are needed to confirm these findings.
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akbulut
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Kucuktopcu
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kandemir
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Sonmezay
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Abdulmuttalip
authors.initials: A
authors.lastname: Simsek
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Ahmet Yaser
authors.initials: AY
authors.lastname: Muslumanoglu
authors.affiliation: a Department of Urology , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gurbuz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000706:statistics & numerical data*
keywords: Flexible ureterorenoscopy; complications; lower calyx; mini-percutaneous nephrolithotomy; success