Comparison of stone-free rate between percutaneous nephrolithotomy and retrograde intrarenal surgery

Q: What was the main aim of the study?

To compare the stone-free rate (SFR) between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones.

Q: Who were the included patients?

Retrospective review included patients with renal stones scheduled for surgery from June 2016 to June 2018, focusing on stone size between 10 mm and 20 mm and excluding several high-risk or complex stone categories.

Q: How did PCNL and RIRS compare in outcomes?

SFR was not significantly different between PCNL and RIRS. RIRS had a significantly longer operation time but a significantly shorter hospital stay.

Sep 29, 2026

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Management of kidney urolithiasis has evolved with endourology, with three common minimally invasive options: ESWL, PCNL, and RIRS. This study retrospectively compared stone-free rate (SFR) between PCNL and RIRS to clarify outcomes when selecting procedures. Patients with renal stones treated between June 2016 and June 2018 were evaluated using imaging within three months. PCNL and RIRS achieved similar SFR, while RIRS required longer operative time and resulted in shorter hospital stays.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

1. Introduction

2. Methods

J Chin MedAssoc Original article Comparison of stone-free rate between percutaneous nephrolithotomy and retrograde intrarenal surgery Peng Chena, Tony Tzu-Chun Weia,*, Eric Yi-Hsiu Huanga,b, Tzu-Ping Lina,b, Tzu-Hao Huanga,b, Chih-Chieh Lina,b, I-Shen Huanga,b, William J. Huanga,b aDepartment of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDepartment of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC Abstract Background: The management of urolithiasis in the kidney has been drastically changed in the era of endourology, mainly consisting of three surgical procedures: extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS) . Since ESWL is usually less invasive via ambulatory clinic routes, this study aimed to examine the stone-free rate (SFR) between PCNL and RIRS. Methods: We retrospectively reviewed patients who had renal stones and were treated with either PCNL or RIRS from June 2016 to June 2018. Staghorn stones, stones with diameters <1 cm, and stones with diameters >2 cm were excluded. Patients who underwent multiple surgeries for bilateral renal stones and those with graft kidney stones were excluded from the study. X-ray, sonography, and/or computed tomography (CT) were used to calculate the size of the stones. Follow-up was evaluated by the same image examination within three months after surgery. Stone-free was defined as no residual stone or the presence of asymptomatic calculi <4 mm. The operation time was defined as a skin-to-skin interval. Results: Following exclusion criteria, there were 39 patients in each arm, with no difference in age, sex, or any other demographic data. The average stone size in the PCNL and RIRS groups was 16.3 and 14.0 mm, respectively (p = 0.009) . There was no significant difference in SFR (71 .8% vs 61.5%, p = 0.337); the operation time was significant longer (p < 0.001), and the hospital stay was significantly shorter (p < 0 .001) in the RIRS group. Conclusion: PCNL and RIRS are both feasible options for managing kidney stones. However, the initial stone size might affect the selection of operation. The SFR in the PCNL group was numerically but not statistically higher. The RIRS group, on the other hand, had a longer operation time but a shorter hospital stays. Keywords: Percutaneous nephrolithotomy; Retrograde intrarenal surgery; Stone-free; Urolithiasis 1. INTRODUCTION The optimal management of renal calculi has always been an issue, despite advances in endourological equipment and techniques that have made minimally invasive surgeries more feasible with less complication. According to the European Association of Urology guidelines, percutaneous nephrolithotomy (PCNL) is preferable over retrograde intrarenal surgery (RIRS) or extracorporeal shock wave lithotripsy (ESWL) for renal calculi larger than 20 mm. On the other hand, RIRS or ESWL may be preferred *Address correspondence. Dr. Tony Tzu-Chun Wei, Department of Urology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: [tony720714@gmail.com](tony720714@gmail.com) (T.-C. Wei). Conflicts of interest: Dr. William J. Huang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2023) 86: 485-488. Received May 5, 2022; accepted January 31, 2023. doi: 10. 1097/JCMA.0000000000000913. Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[

FAQs

What was the main aim of the study?

To compare the stone-free rate (SFR) between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones.

Who were the included patients?

Retrospective review included patients with renal stones scheduled for surgery from June 2016 to June 2018, focusing on stone size between 10 mm and 20 mm and excluding several high-risk or complex stone categories.

How did PCNL and RIRS compare in outcomes?

SFR was not significantly different between PCNL and RIRS. RIRS had a significantly longer operation time but a significantly shorter hospital stay.

Sep 29, 2026

Upload by Sarah