KUBİLAY SARIKAYA, ÇAĞRİ ŞENOCAK, MEHMET ÇİFTÇİ, MUHAMMED ARİF İBİŞ, ÖMER FARUK BOZKURT
Anatolian Current Medical Journal - 2021;3(2):165-170
Objective: To compare the efficacy of combined semi-rigid+ flexible ureterorenoscopic surgery (URS+RIRC) and percutaneous nephrolithotomy (PNL), which is the standard method for the surgery of ≥2 cm upper ureteral impacted stones. Material and Method: The data of 123 patients who underwent stone surgery for ≥2 cm impacted ureteral stones in the upper ureter in our clinic were retrospectively analyzed. The patients were divided into two groups as URS+RIRC ( n=59) and PNL ( n=64) according to the type of operation. Patients with stones impacted in the ureter at the level between the L4 vertebra and ureteropelvic junction were included in the study. Preoperative demographic data and postoperative results of the patients in two groups were compared. Results: Average operation time was similar in both groups (p=0.147). Mean hospital stay was significantly higher in the PNL group compared to the URS+RIRC group (3.28±0.57 days vs 1.11±0.32 days, p=0.001). Mucosal injury was developed in 10 (16.9%) patients in the URS+RIRC group during the operation, while it was only 3 (4.7%) in the PNL group (p=0.027). Postoperative urinary tract infection development was found to be similar in URS+RIRC and PNL groups (8.5% vs 4.7%, p=0.479).Postoperativestone-free rate was found to be significantly higher in the PNL group compared to the URS+RIRC group (95.3% vs 79.7%, p=0.008). Conclusion: PNL is a very effective and safe procedure in the surgical treatment of stones ≥2 cm in diameter impacted in the upper ureter. The complication rate of PNL is comparable with URS+RIRC; however, it is seen that the PNL is more advantageous than URS+RIRC in terms of postoperative total stone-free rate.
