[Flexible ureterorenoscopy vs percutaneous nephrolithotomy for renal stone management: Retrospective study].
OBJECTIVE
The aim of this study was to evaluate the efficacy and tolerance of renal stone fragmentation by flexible ureterorenoscopy (URS), compared to percutaneous nephrolithotomy (PCNL).


METHODS
Patients treated between 1998 and 2010 by URS and PCNL for intrarenal stone were reviewed. Patients' and stones' characteristics were analyzed. The preoperative parameters were reported as well as the procedure's efficiency and its complications. Success was defined by the absence of residual lithiasis visualized on renal imaging at 6 months of follow-up.


RESULTS
Among 531 patients included, there were 159 PCNL and 372 URS. The mean duration of hospitalization after PCNL was 8±4.6 days and 3±1.7 days after URS. The mean stones' size was higher in the PCNL group (19.9±7.5mm) than for the URS group (9.7±5.6mm; P<0.0001). The stone-free rate was significantly better in the PCNL group for stones measuring between 10 and 20mm (P<0.0001) and for stones of more than 20mm (P=0.017). Postoperative complications were significantly more frequent (27 %) and more severe (8.8 % vs Clavien III and IV) in the PCNL, than in the URS group, respectively (P=0.0001).


CONCLUSIONS
PCNL is a successful technique for renal stone fragmentation. However, URS seemed more tolerated despite a lower stone-free rate.


METHODS
4.
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; UFR sciences médicales et pharmaceutique, université de Franche-Comté, 25030 Besançon cedex, France.
X
X
Palmero
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France.
L
L
Balssa
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France.
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S
Bernardini
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France.
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E
Chabannes
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France.
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G
Guichard
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; UFR sciences médicales et pharmaceutique, université de Franche-Comté, 25030 Besançon cedex, France.
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H
Bittard
Service d'urologie et de transplantation rénale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; UFR sciences médicales et pharmaceutique, université de Franche-Comté, 25030 Besançon cedex, France; Inserm UMR 1098, Besançon, France. Electronic address: francois.kleinclauss@univ-fcomte.fr.
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F
Kleinclauss
D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications; D012189:Retrospective Studies; D018666:Ureteroscopy
Calcul rénaux; Complications opératoires; Néphrolithotomie percutanée; Percutaneous nephrolithotomy; Postoperative complication; Renal stone; Stone free rate; Taux sans fragment résiduel; Ureterorenoscopy; Urétérorénoscopie souple