📃 Paper Title: Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse
🧍 Author: Mathew D Sorensen
🕒 Year: 2022
📚 Journal: The New England Journal of Medicine
🌎 Country: USA
ㅤContext to the study:
Can you tell me about a trial that highlighted the benefits of removing concurrent asymptomatic renal stones whilst performing surgery for the removal of symptomatic stones?
ㅤ✅ Take-home message of study:
The removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral kidney stones resulted in an 82% lower incidence of relapse than non-removal.
ㅤ Randomised Controlled Trial
ㅤ
Study participants:
Number included: 75 (Treatment group 39; Control group 36)
Inclusion criteria:
Aged >= 21 years
Patients scheduled to undergo endoscopic surgical treatment of a primary stone
Patients who had one or more secondary stones on computed tomography (CT) within 90 days before randomization
Treatment: Secondary stones in patients in the treatment group were removed by ureteroscopy but not in the control group
For both groups: Postoperative imaging with low-dose CT 90 days after surgery and
then approximately once a year thereafter. Follow-up every 3 monthly, for up to 5 years
ㅤ
ㅤ
Key study outcomes:
Median follow-up: 4.2 years
Time to relapse was 75% longer in the treatment group than in the control group
Risk of relapse was 82% lower in the treatment group than the control group [Treatment group: 16% Control group: 63%]
Longer surgery time (by 25.6 minutes) in the treatment group
Similar number of emergency department visits related to the surgery
ㅤ
ㅤ
Study Limitations:
Small sample size precludes subgroup analysis of surgical technique
ㅤ