Endoscopic combined intrarenal surgery versus prone percutaneous nephrolithotomy for complex renal stones: critical assessment of a randomized trial

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Noah K.; Algamal K.; Elliethy T.; Saber W.; Mobark M.; Alhefnawy M.

Journal: International Urology and Nephrology

Publisher: Springer Science and Business Media B.V.

Publication Date: 29 March 2025

Volume / Issue: Volume 57 / Issue 10

Pages: 3087–3095

ISSN: 3011623

DOI: 10.1007/s11255-025-04445-x

Scopus: View on Scopus

PubMed: 40156645

Document Type: Review

Authors and Affiliations

Noah K., Urology Department, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom, Urology Department, Banha University Hospital, Banha, Egypt; Algamal K., Urology Department, Banha University Hospital, Banha, Egypt; Elliethy T., Urology Department, Theodor Bilharz Research Institute, Giza, Egypt; Saber W., Urology Department, Banha University Hospital, Banha, Egypt; Mobark M., Urology Department, Banha University Hospital, Banha, Egypt; Alhefnawy M., Urology Department, Banha University Hospital, Banha, Egypt

Abstract

Objective: To evaluate the efficacy and safety of endoscopic combined intrarenal surgery (ECIRS) in the Galdakao-Modified Supine Valdivia (GMSV) position versus percutaneous nephrolithotomy (PCNL) in the prone position for managing complex kidney stones. Methods: This prospective, randomized study was conducted in the urology departments of Benha University Hospital and Theodor Bilharz Research Institute between June 2021 and May 2024. A total of 60 patients with complex renal stones were randomly assigned to two groups (30 patients each). Group A underwent conventional percutaneous nephrolithotomy (PCNL) in the prone position, while Group B underwent endoscopic combined intrarenal surgery (ECIRS) in the Galdakao-Modified Supine Valdivia (GMSV) position. Data on demographic characteristics, clinical outcomes, perioperative parameters, and stone-free rates (SFR) were collected. Results: No significant differences were found between the two groups regarding preoperative demographic data and stone characteristics. However, operative time was significantly longer in the PCNL group (119 ± 18 min) compared to the ECIRS group (105 ± 14 min) (P = 0.002). The number of punctures was also significantly higher in the PCNL group than in the ECIRS group (P = 0.001). Immediate success was notably higher in the ECIRS group (83.3%) compared to the PCNL group (53.3%) (P = 0.012). However, no significant difference was observed between the groups concerning eventual success (P = 1.0). Conclusion: ECIRS is a highly effective treatment for complex renal stones, delivering favorable outcomes such as higher single-step stone-free rates, a lower incidence of adverse events, and a reduced need for auxiliary procedures. © Crown 2025.

Keywords

ECIRS; GMSV position; PCNL; Renal stones; Stone-free rate; Adult; Endoscopy; Female; Humans; Kidney Calculi; Male; Middle Aged; Nephrolithotomy, Percutaneous; Patient Positioning; Prone Position; Prospective Studies; Treatment Outcome; clinical outcome; controlled study; human; incidence; kidney colic; major clinical study; multicenter study; nephrolithiasis; operation duration; percutaneous nephrolithotomy; randomized controlled trial; review; surgery; comparative study; procedures; prospective study

Citation Information

Scopus Citations: 6

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