[Flexible ureteroscopy and mini percutaneous nephrolithotomy in the treatment of renal lithiasis less or equal to 2 cm]. / Urétéroscopie souple et mini néphrolithotomie percutanée dans le traitement des calculs pyélo-caliciels inférieurs ou égaux à 2cm.

ABSTRACT

PURPOSE: Compare, in a retrospective study, the indications, the efficiency and the morbidity of the flexible ureteroscopy (URS) and the mini percutaneous nephrolithotomy (mini-perc) for the treatment of the renal lithiasis less or equal to 2 cm. MATERIALS AND METHODS: One hundred and forty-four operated patients 101 by "mini-perc" and 43 by URS. Pre-, per- and post-operative data prospectively entered in a computerized database. RESULTS: URS and "mini-perc" groups were comparable in terms of age (49.2±14 years versus 51.7±16 years; P=0.37) and of size of the lithiasis (8.5±3.2 mm versus 8.9±2.7 mm, P=0.4). However, the number of lithiasis was more important in URS group (2.7±141.6 versus 1.3±0.38; P<0.05). The operating time was 59±32.6 min in URS and 48±28.3 min "mini-perc" group (P=0.05). The peroperating complication rate was 2% for URS (a false passage during the introduction of the access girdle) and null in the "mini-perc" group. The hospitalization was 1.49±11.4 days after URS and of 4.1±1.2 days after "mini-perc" (P<0.05). The duration of ureter drainage by stent was respectively 13.8±11.5 and 2.6±1.2 days (P<0.05). One month later, the treatment was effective in 88% of cases in the URS group whereas 93% in "mini-perc" group (P=0.17). Six patients (14%) need complementary treatment for residual lithiasis in the URS group and four (3.9%) in the "mini-perc" group. CONCLUSION: The "mini-perc" and the URS are two effective techniques for the treatment of the renal lithiasies less or equal to 2 cm. For the two groups, the complication rates were low and the length of hospital stay was short.