title: Percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones up to 2 cm in patients with solitary kidney: a single centre experience.
abstract: BACKGROUND
  To compare the treatment outcomes between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the management of stones larger than 2 cm in patients with solitary kidney.
  
  
  METHODS
  One hundred sixteen patients with a solitary kidney who underwent RIRS (n = 56) or PCNL (n = 60) for large renal stones (>2 cm) between Jan 2010 and Nov 2015 have been considered. The patients' characteristics, stone characteristics, operative time, incidence of complications, hospital stay, and stone-free rates (SFR) have been evaluated.
  
  
  RESULTS
  SFRs after one session were 19.6% and 35.7% for RIRS and PCNL respectively (p = 0.047), but the SFR at 3 months follow-up comparable in both groups (82.1% vs. 88.3%, p = 0.346). The calculated mean operative time for RIRS was longer (p < 0.001), but the mean postoperatively hospital stay was statistically significantly shorter (p < 0.001) and average drop in hemoglobin level was less (p = 0.040). PCNL showed a higher complication rate, although this difference was not statistically significant.
  
  
  CONCLUSIONS
  Satisfactory stone clearance can be achieved with multi-session RIRS in the treatment of renal stones larger than 2 cm in patients with solitary kidney. RIRS can be considered as an alternative to PCNL in selected cases.
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yunjin
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yubo
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China. wangjiawch@163.com.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
mesh_terms: D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D007669:Kidney Calculi / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies
keywords: Percutaneous nephrolithotomy; Retrograde intrarenal surgery; Solitary kidney