title: Is it necessary to actively remove stone fragments during retrograde intrarenal surgery?
abstract: Based on the experiences of our center, we sought to verify the necessity of actively removing stones during retrograde intrarenal surgery (RIRS) for the management of renal stones.
  
  
  
  From March 2010 to March 2015, 248 patients underwent RIRS at our center. We classified these patients into 2 groups according to the performance of active stone removal; group A (n=172) included the patients whose stones were actively removed using a stone basket, and group B (n=76) included the patients whose stones were fragmented with laser lithotripsy without active removal of the fragments. We retrospectively compared the operation time, success rate, and complication rate between the 2 groups.
  
  
  
  There were no significant differences between groups A and B in terms of mean age (56.1 years vs. 58.6 years), male to female ratio (115:57 vs. 46:30), mean body mass index (24.5 kg/m(2) vs. 25.0 kg/m(2)), mean preoperative size of stone (11.1 mm vs. 11.1 mm), the ratio of unilateral and bilateral stones (136:36 vs. 64:12), success rate (89.0% vs. 86.8%), operation time (82.5 minutes vs. 82.1 minutes), overall complication rate (9.9% vs. 11.8%), incidence of febrile urinary tract infection (6.4% vs. 2.6%), gross hematuria (1.7% vs. 2.6%), or postoperative de novo hydronephrosis (2.9% vs. 5.3%).
  
  
  
  This study demonstrated that during RIRS, fragmentation only, without the active removal of stones, is a safe and effective technique in which the surgical outcomes are comparable to those of procedures involving the active removal of stones.
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Dong Jae
authors.initials: DJ
authors.lastname: Bak
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jae-Wook
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jun Nyung
authors.initials: JN
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyun Tae
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Eun Sang
authors.initials: ES
authors.lastname: Yoo
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Bum Soo
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007669:Kidney Calculi / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology
keywords: Kidney calculi; Lasers; Lithotripsy; Ureteroscopy