Comparison of Conventional Percutaneous Nephrolithotomy and Endoscopic Combined Intrarenal Surgery with Respect to Efficacy and Safety in Complex Renal Stone

Abstract

When PCNL and RIRS alone are unable to completely clear complex renal calculi, a combination of the two modalities was tested. Endoscopically Combined Intra Renal Surgery (ECIRS) is name given to this procedure afterwards. It excludes the drawbacks of multi-puncture PCNL and simultaneously provides much higher stone free rates. ECIRS is a relatively new tool in the arsenal of urologists, and as of right now, there isn't much information available in developing nations.

Methods: A Comparative Observational study where 40 patients were split into two groups of 20, one for ECIRS and the other for prone PCNL. Both groups' surgical times, stone removal rates, potential complications, and other post-operative results were compared.

Results: The majority of the patients (26) were men between the ages of 36 and 45, and both the group's age and gender were similar. The average calculus size was 2.43 cm for the ECIRS group and 2.60 cm for the prone PCNL group. Mean duration of the surgery was 85.24 & 88.12 min in ECIRS and prone PCNL group respectively. In the ECIRS group, the stone-free rate was considerably greater with lesser requirement of additional punctures and blood transfusions. More ancillary procedures prone PCNL patients' hospital stays were observed, as well. Post-operative S. urea and S. creatinine, fever, pain, post-operative complications were comparable.

Conclusion: In view of the findings of the study, ECIRS seems to be a better option in comparison to prone PCNL in terms of effectiveness and safety.