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A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones.
World J Urol 2017; 35(12):1967-1975WJ

Abstract

PURPOSE

To prospectively evaluate the efficacy and safety of RIRS, SWL and PCNL for lower calyceal stones sized 1-2 cm.

MATERIALS AND METHODS

Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this multicenter, randomized, unblinded, clinical trial study. Patients were randomized into three groups: group A: SWL (194 pts); group B: RIRS (207 pts); group C: PCNL (181 pts). Patients were evaluated with KUB radiography (US for uric acid stones) at day 10 and a CT scan after 3 months. The CONSORT 2010 statement was adhered to where possible. The collected data were analyzed.

RESULTS

The mean stone size was 13.78 mm in group A, 14.82 mm in group B and 15.23 mm in group C (p = 0.34). Group C compared to group B showed longer operative time [72.3 vs. 55.8 min (p = 0.082)], fluoroscopic time [175.6 vs. 31.8 min (p = 0.004)] and hospital stay [3.7 vs. 1.3 days (p = 0.039)]. The overall stone-free rate (SFR) was 61.8% for group A, 82.1% for group B and 87.3% for group C. The re-treatment rate was significantly higher in group A compared to the other two groups, 61.3% (p < 0.05). The auxiliary procedure rate was comparable for groups A and B and lower for group C (p < 0.05). The complication rate was 6.7, 14.5 and 19.3% for groups A, B and C, respectively.

CONCLUSIONS

RIRS and PCNL were more effective than SWL to obtain a better SFR and less auxiliary and re-treatment rate in single lower calyceal stone with a CT diameter between 1 and 2 cm. RIRS compared to PCNL offers the best outcome in terms of procedure length, radiation exposure and hospital stay. ISRCTN 55546280.

Authors+Show Affiliations

Department of Urology, Humanitas Mater Domini, Via Gerenzano 2, 21053, Castellanza, Varese, Italy. gioboz@yahoo.it. ESUT European Section for UroTechnology, Arnhem, Netherlands. gioboz@yahoo.it.Department of Urology, University of Naples Federico II, Naples, Italy.Department of Urology, Second University of Naples, Naples, Italy.Universitätsklinik für Urologie, Graz, Austria.Humanitas University, Milan, Italy.Humanitas University, Milan, Italy.Humanitas University, Milan, Italy.Department of Urology, Lomonosov Hospital, Moscow, Russia.Department of Urology, London Barts Hospital, London, UK. ESUT European Section for UroTechnology, Arnhem, Netherlands.Department of Urology, Policlinico di Milano, Milan, Italy.ASST San Paolo, Milan, Italy.Universitätsklinik für Urologie, Graz, Austria.Department of Urology, University of Naples Federico II, Naples, Italy.Department of Urology, Second University of Naples, Naples, Italy.Department of Urology, Humanitas Mater Domini, Via Gerenzano 2, 21053, Castellanza, Varese, Italy.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

28875295

Citation

Bozzini, G, et al. "A Prospective Randomized Comparison Among SWL, PCNL and RIRS for Lower Calyceal Stones Less Than 2 Cm: a Multicenter Experience : a Better Understanding On the Treatment Options for Lower Pole Stones." World Journal of Urology, vol. 35, no. 12, 2017, pp. 1967-1975.
Bozzini G, Verze P, Arcaniolo D, et al. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. World J Urol. 2017;35(12):1967-1975.
Bozzini, G., Verze, P., Arcaniolo, D., Dal Piaz, O., Buffi, N. M., Guazzoni, G., ... Taverna, G. (2017). A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. World Journal of Urology, 35(12), pp. 1967-1975. doi:10.1007/s00345-017-2084-7.
Bozzini G, et al. A Prospective Randomized Comparison Among SWL, PCNL and RIRS for Lower Calyceal Stones Less Than 2 Cm: a Multicenter Experience : a Better Understanding On the Treatment Options for Lower Pole Stones. World J Urol. 2017;35(12):1967-1975. PubMed PMID: 28875295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: a multicenter experience : A better understanding on the treatment options for lower pole stones. AU - Bozzini,G, AU - Verze,P, AU - Arcaniolo,D, AU - Dal Piaz,O, AU - Buffi,N M, AU - Guazzoni,G, AU - Provenzano,M, AU - Osmolorskij,B, AU - Sanguedolce,F, AU - Montanari,E, AU - Macchione,N, AU - Pummer,K, AU - Mirone,V, AU - De Sio,M, AU - Taverna,G, Y1 - 2017/09/05/ PY - 2017/06/14/received PY - 2017/08/22/accepted PY - 2017/9/7/pubmed PY - 2018/7/20/medline PY - 2017/9/7/entrez KW - Lower pole stone KW - PCNL KW - RIRS KW - SWL SP - 1967 EP - 1975 JF - World journal of urology JO - World J Urol VL - 35 IS - 12 N2 - PURPOSE: To prospectively evaluate the efficacy and safety of RIRS, SWL and PCNL for lower calyceal stones sized 1-2 cm. MATERIALS AND METHODS: Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this multicenter, randomized, unblinded, clinical trial study. Patients were randomized into three groups: group A: SWL (194 pts); group B: RIRS (207 pts); group C: PCNL (181 pts). Patients were evaluated with KUB radiography (US for uric acid stones) at day 10 and a CT scan after 3 months. The CONSORT 2010 statement was adhered to where possible. The collected data were analyzed. RESULTS: The mean stone size was 13.78 mm in group A, 14.82 mm in group B and 15.23 mm in group C (p = 0.34). Group C compared to group B showed longer operative time [72.3 vs. 55.8 min (p = 0.082)], fluoroscopic time [175.6 vs. 31.8 min (p = 0.004)] and hospital stay [3.7 vs. 1.3 days (p = 0.039)]. The overall stone-free rate (SFR) was 61.8% for group A, 82.1% for group B and 87.3% for group C. The re-treatment rate was significantly higher in group A compared to the other two groups, 61.3% (p < 0.05). The auxiliary procedure rate was comparable for groups A and B and lower for group C (p < 0.05). The complication rate was 6.7, 14.5 and 19.3% for groups A, B and C, respectively. CONCLUSIONS: RIRS and PCNL were more effective than SWL to obtain a better SFR and less auxiliary and re-treatment rate in single lower calyceal stone with a CT diameter between 1 and 2 cm. RIRS compared to PCNL offers the best outcome in terms of procedure length, radiation exposure and hospital stay. ISRCTN 55546280. SN - 1433-8726 UR - https://www.unboundmedicine.com/medline/citation/28875295/A_prospective_randomized_comparison_among_SWL_PCNL_and_RIRS_for_lower_calyceal_stones_less_than_2_cm:_a_multicenter_experience_:_A_better_understanding_on_the_treatment_options_for_lower_pole_stones_ L2 - https://dx.doi.org/10.1007/s00345-017-2084-7 DB - PRIME DP - Unbound Medicine ER -