People with large or complex kidney stones often face a difficult choice between surgical options. A new analysis of 1,988 patients compares two main methods: Endoscopic combined intrarenal surgery, or ECIRS, and percutaneous nephrolithotomy, or PCNL. PCNL has long been the standard for big stones, but this new look at the data suggests ECIRS might be the better choice for many.
The results show ECIRS leads to a significantly higher chance of being stone-free after just one session. Patients also needed fewer extra treatments to finish the job. Importantly, the rate of major complications was lower with ECIRS. This includes fewer cases requiring blood transfusions.
However, the surgery did take longer and patients stayed in the hospital longer when PCNL was used. The analysis notes that most of the data comes from single-center studies that looked back at past records. This means the evidence is not from large, forward-looking trials. Still, the findings suggest ECIRS could reduce time and stay in the hospital, especially when done by experienced surgeons.