Tratamiento de la Litiasis Renal en Cáliz Inferiorlitotricia Extracorpórea versus Cirugía Intrarrenal Retrógrada o Percutánea

  1. Orihuela-Arroyo, Beatriz
  2. Arrabal-Polo, Miguel Ángel
  3. Arrabal-Martín, Miguel
Journal:
Actualidad médica

ISSN: 0365-7965

Year of publication: 2018

Tome: 103

Issue: 804

Pages: 66-71

Type: Article

DOI: 10.15568/AM.2018.804.OR02 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Actualidad médica

Sustainable development goals

Abstract

Introduction: extracorporeal shockwave lithotripsy (SWL) is used in the 80-90% of the cases of renal lithiasis. Endourological techniques such as retrograde intrarenal surgery (RIRS) or percutaneous nephrolithotomy (PCNL) and its miniaturizations (miniperc) are gaining importance because they are highly effective treatments. Regarding the treatment of the nephrolithiasis of the lower pole, the extracorporeal lithotripsy presents worse results, but it still difficult to set up the indications to treat with a certain technique. The purpose of this review is to stablish the effectivity and safety profile of these techniques in the management of the lower renal pole lithiasis. Materials and Methods: we conducted a review of 12 studies that evaluate results of one, two or three of the techniques in terms of effectivity, operative time, hospital stay, complications, auxiliary procedures and re-treatment. Results: SWL presents lower stone-free rates when the lithiasis is medium or big sized, shorter operative time and hospital stay, more complications and high rates of re-treatment. The effectivity of RIRS and PCNL does not change a lot with larger lithiasis, presenting good results and lower residual lithiasis rates. The longer operative time was performed with RIRS and the longer hospital stay with PCNL. The complications rate varies, being more important with PCNL. Re-treatment rates are low with RIRS and PCNL. Conclusions: these three techniques show good results in the management of lower pole lithiasis, although SWL presents worse results in comparison, but considering its reduced invasiveness and short hospital stay, it is the chosen technique for many patients. Endourological techniques show better results at expense of their invasiveness and higher cost, although sometimes they are preferable in order to prevent re-treatment.

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