Stone;Renal Clinical Trial
Official title:
Flexible Ureteroscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study.
Management of nephrolithiasis is evolving rapidly, and various minimally-invasive urological
procedures are currently available for treating patients with renal stones, including
extracorporeal shockwave lithotripsy (ESWL), flexible ureteroscopy (f-URS) and miniaturised
percutaneous nephrolithotomy (mini-PCNL).
Despite being the only truly-non-invasive, outpatient procedure, stone-free rates (SFRs) of
ESWL are lower than both mini-PCNL and f-URS. Furthermore, ESWL has several limitations, such
as pregnancy; uncorrected coagulopathy;aortic aneurism; severe obesity; large stone burdens
(>2cm); stones with high densities (>970/1000 Hounsfield units); ESWL-resistant stone
compositions; lower calyceal stones with unfavourable anatomical criteria; and stones in
calyceal diverticula; Morbidities of the conventional PCNL are significantly minimised by
using less access diameters in PCNL while providing comparable SFRs. Additionally, Mini and
Micro PCNL result in shorter hospital stay and higher tubeless rates compared to conventional
PCNL.
Flexible ureteroscopy has been increasingly used as a primary modality for treatment of renal
stones with significantly lower complication rates than PCNL and mini-PCNL in terms of less
bleeding and transfusion rates, shorter hospital stay and less postoperative pain.
Additionally, f-URS is the only treatment modality of nephrolithiasis that can be safely and
effectively used in patients with bleeding tendency, as well as pregnant women; moreover, its
outcomes are not affected by obesity. Nevertheless, its poor durability and high costs remain
major limitations for f-URS, especially in developing countries.
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Status | Clinical Trial | Phase | |
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Active, not recruiting |
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Mini- Percutaneous Nephrolithotomy Versus Standard Percutaneous Nephrolithotomy in the Treatment of Renal Stones.
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Completed |
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