Comparison of Lithotomy Versus Lateral Position in Retrograde Intrarenal Surgery for Lower Calyceal Stones Less Than 2 cm: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Menoufia University
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Stone Free Rate
Overview
Brief Summary
Retrograde intrarenal surgery (RIRS) is an established minimally invasive treatment for renal stones, particularly for lower calyceal stones less than 2 cm, offering acceptable stone-free rates with low morbidity.
However, stone clearance in the lower calyx remains technically challenging due to unfavorable anatomy, limited scope deflection, and gravity-dependent fragment retention. Patient positioning during RIRS has been suggested as a modifiable factor that may influence endoscopic access, stone relocation, and surgical ergonomics.
The lithotomy position is conventionally used during RIRS, while the lateral position has been proposed to facilitate stone migration and improve lower calyceal access through gravitational assistance. Existing studies comparing patient positioning during RIRS are limited, with most evidence derived from retrospective analyses or non-randomized designs.
Therefore, this randomized controlled trial aims to compare lithotomy versus lateral positioning during RIRS for lower calyceal stones less than 2 cm in terms of operative and clinical outcomes.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adults aged ≥18 years.
- •Single or multiple lower calyceal renal stones with stone size \<2 cm confirmed by NCCT.
- •Negative urine culture.
- •Presented cases.
Exclusion Criteria
- •Multiple stones involving renal pelvis or other calyces.
- •Anatomical anomalies affecting ureteroscope access (horseshoe kidney, malrotation, ureteral strictures).
- •Pregnancy.
- •Prior ipsilateral renal surgery.
Outcomes
Primary Outcomes
Stone Free Rate
Time Frame: 1 month
Stone-free rate (SFR), defined as no clinically significant residual stones on non-contrast 3-mm-cuts CT, measured as yes or no
Secondary Outcomes
- Operative time(The operative time)
- Complications(1 month)
Investigators
Ammar Fathi Mohamed AlOrabi
Dr
Menoufia University