[28] Retrograde intra-renal surgery as a treatment modality for unilateral renal calyceal stones of 1–2 cm

Objective

To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) as a treatment modality for renal calyceal stones measuring 1–2 cm.

Methods

Between July 2015 and January 2017, 78 patients (60 males and 18 females) ranging in age between 22 and 60 years, diagnosed as having a solitary, unilateral renal stone of 1–2 cm were included in this study and underwent RIRS. Patients were classified into three groups according to their stone location; Group I [27 (34.6%) patients] with upper calyceal stones, Group II [26 (33.4%) patients] with middle calyceal stones, and Group III [25 (32%) patients] with lower calyceal stones. All patients were evaluated preoperatively by complete history, clinical examination, laboratory and radiological investigations. All patients were treated with RIRS and evaluated postoperatively for stone-free rate (SFR), operative time, hospital stay, and complications.

Results

The overall SFR in our study was 84.6% (66 patients). It was 88.9%, 84.6% and 80% for groups I, II and III, respectively. Residual stones of $>$4 mm were identified in three (11.1%), four (15.4%) and five (20%) patients in groups I, II and III, respectively. Postoperative complications occurred in four (5.13%) patients, including two with postoperative fever (one each in groups II and III) and another two with postoperative haematuria (one each in groups I and III). All of these complications were treated conservatively.

Conclusion

RIRS is a promising, safe and effective modality of treatment for calyceal stones measuring 1–2 cm with minimal complications and should be considered the treatment of choice when extracorporeal shockwave lithotripsy is contraindicated in such cases.