Background: To compare the efficacy and safety of simultaneous percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy in Galdakao-Modified Supine Valdivia position (GMSV) with percutaneous nephrolithotomy (PCNL) for complex renal stones.
Methods: 60 patients with complex renal stones. were randomly divided into two groups. In PCNL Group, conventional PCNL was performed in the prone position. In the other group, simultaneous combined PCNL and flexible ureteroscopic lithotripsy (Endoscopic Combined Intra-Renal Surgery, ECIRS) serves as single session treatment in the GMSV position (ECIRS Group). Demographic, clinical
characteristic, perioperative complications and stone free rate (SFR) were recorded.
Results: No significant differences were observed between both groups regarding age, sex, body mass index, side, and Guy’s score. Operative time was significantly higher in PCNL group (111 81± minutes) than in ECIRS group (105 814 minutes) (P = 00002). A significant association was observed in the number of punctures, it was higher in PCNL group than in ECIRS group (P = 00001). Hospital stay was significantly higher in the PCNL group (median = 3, range = 3 – 10) than in the ECIRS group (median = 2, range = 2 - 6) (P < 00001). On day one, KUB or CT revealed significantly higher residual in the PCNL group (46064) than in the ECIRS group (16064) (P = 00012).The immediate success was significantly higher in the ECIRS group (±3034) than in the PCNL group (53034) (P = 00012). The auxiliary procedures required for all patient with significant residual stone(s) and reveled significantly higher in the PCNL group (46064) than in the ECIRS group (16064) (P = 00012) but no significant differences were reported between both groups regarding the types of auxiliary procedure (P = 100) |
