Efficacy and safety of flexible ureteroscopy with a navigable suction ureteral access sheath versus mini-percutaneous nephrolithotomy for 2–3 cm renal stones: a retrospective study

Aloyan A.A., Zulkarnaev A.B., Iskanderov A.M., Aloyan Zh.S., Martov A.G., Gadzhiev N.K.

1) Saint Petersburg State University Clinic, Saint Petersburg, Russia; 2) M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; 3) Medical and Biological University of Innovation and Continuing Education, A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical-Biological Agency of Russia, Moscow, Russia; 4) Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia

Introduction. Flexible ureteroscopy using a flexible and navigable suction ureteral access sheath (FANS f-URS) has expanded the possibilities of endoscopic treatment of renal stones; however, its role in the management of renal stones ≥2 cm remains controversial. Aim. To compare the efficacy and safety of FANS f-URS and mini-percutaneous nephrolithotomy (mini-PCNL) for the treatment of 2–3 cm renal stones. Materials and methods. This retrospective study included 39 patients who underwent endoscopic surgical treatment, including 19 patients who underwent FANS f-URS and 20 who underwent mini-PCNL. Baseline characteristics as well as intraoperative and postoperative outcomes were collected and compared between the two groups. Results. On the first postoperative day, the stone-free rate, defined as residual fragments ≤2 mm, was 78.9% in the FANS f-URS group and 50.0% in the mini-PCNL group (p=0.096). At 3 months, the stone-free rates were comparable (94.7% for FANS f-URS and 90.0% for mini-PCNL; p>0.999). FANS f-URS was associated with a smaller decrease in hemoglobin level (p<0.001), a lower postoperative leukocyte count (p=0.023), and a shorter hospital stay (p<0.001; the proportion of patients with a hospital stay of 1–2 days was 100.0% vs. 40.0%). The complication rate and incidence of infectious events did not differ between the groups. Both groups demonstrated a statistically significant improvement in quality of life, with no difference in the magnitude of change between the groups (p=0.081). Conclusion. FANS f-URS provides efficacy comparable to that of mini-PCNL for 2–3 cm renal stones, while offering a more favorable safety profile and postoperative recovery.

Keywords

About the Authors

Corresponding author: A.A. Aloyan – Urologist, Department of Urology, Saint Petersburg State University Clinic, Saint Petersburg, Russia; e-mail: dr.aramaloyan@gmail.com

Similar Articles