Title: Retrograde ureteroscopic intrarenal surgery for renal calculus larger than 1.5 cm
Authors: Naveed Khan, Mohamad Ommid, Sheela Rani, Syed Sajad Nazir, Muneer Khan
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.129
Abstract
Objective: To assess the feasibility of retrograde ureteroscopic intrarenal surgery (RIRS) as a viable alternate to percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculus greater than 1.5 cm.
Materials and Methods: From March 2012 to March 2018, an aggregate of 120 instances of renal stones more prominent than 1.5 cm stone weight, were treated by RIRS with adaptable ureteroscope and stones divided with holmium laser. The vast majority of the patients were pre stented before the strategy. Access sheath was utilized in all cases. Olympus advanced video ureterorenoscope was utilized. Patients were released following 24 hours of the system and permitted to continue ordinary work following two days. X beam KUB for radio murky stones and ultrasound for every one of the cases were done following three weeks and if any leftover parts of any size were available the patient was taken up for re-look adaptable ureteroscopy under anesthesia. Stent and remaining pieces were expelled. In the event that there was no build up the stent was evacuated under local anaesthesia.
Results: Complete leeway was considered if there were no pieces on USG screening after three weeks. 40 patients had stone weight more prominent than 150 mm. 80 patients had stone weight under 150 mm. leeway was poor in 30% when the stone weight was more noteworthy than 150mm and 95% when the stone weight was under 150mm. second sitting was required 30% of the patients with bigger than 150mm stone weight and in 5% when the stone weight was under 150mm.
Conclusion: RIRS is a viable methodology with high freedom rates in stones under 150mm. Anyway in stones more prominent than 150mm, the leeway rate uniquely diminishes. Shorter clinic remain, less difficulty, less horribleness and great stone free rate are the benefit of RIRS. RIRS is the best alternative for overseeing extracorporeal shockwave lithotripsy fizzled and post PCNL leftover math. However RIRS ought to be painstakingly utilized for extensive calculi having stone weight of more prominent than 150mm.
Keywords: Kidney stones, flexible ureteroscopy, percutaneous nephrolithotomy, retrograde intrarenal surgery
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