The efficacy of retrograde intra-renal surgery (RIRS) for lower pole stones: results from 2946 patients
Por:
Giulioni, C, Castellani, D, Somani, BK, Chew, B, Tailly, T, Keat, WOL, Teoh, JY, Emiliani, E, Chai, CA, Galosi, AB, Ragoori, D, Tanidir, Y, Hamri, SB, Gadzhiev, N, Traxer, O, Gauhar, V
Publicada:
17 mar 2023
Ahead of Print:
1 mar 2023
Resumen:
PurposeTo evaluate the perioperative outcomes of retrograde intra-renal surgery (RIRS) for lower pole stones (LPS) and factors affecting stone-free rate (SFR).MethodsData from 20 centers were retrospectively reviewed. Inclusion criteria were adult patients, normal renal anatomy, and LPS. Exclusion criteria were bilateral surgery, concomitant surgery for ureteral stones. SFR was defined as a single residual fragment (RF) <= 2 mm and evaluated 3-months after surgery. A multivariable logistic regression analysis was performed to assess factors associated with RF. Statistical significance was set at p value < 0.05.Results2946 patients were included. Mean age and stone size were 49.9 years 10.19 mm, with multiple LPS in 61.1% of cases. Total operation and laser time were 63.89 +/- 37.65 and 17.34 +/- 18.39 min, respectively. Mean hospital stay was 3.55 days. Hematuria requiring blood transfusion and fever/urinary infections requiring prolonged antibiotics occurred in 6.1% and 169 5.7% of cases, while sepsis with intensive-care admission in 1.1% of patients. On multivariate analysis, Multiple stones (OR 1.380), stone size (OR 1.865), and reusable ureteroscopes (OR 1.414) were significantly associated with RF, while Thulium fiber laser (TFL) (OR 0.341) and pre-stenting (OR 0.750) were less likely associated with RF.ConclusionsRIRS showed safety and efficacy for LPS with a mean diameter of 10 mm. This procedure can achieve a satisfactory SFR in pre-stented patients with a single and smaller stone, particularly with TFL use.
Filiaciones:
Giulioni, C:
Polytech Univ Marche, Urol Unit, Azienda Osped Univ Marche, Ancona, Italy
Polytech Univ Marche, Dept Urol, 71 Conca St, I-60126 Ancona, Italy
Castellani, D:
Polytech Univ Marche, Urol Unit, Azienda Osped Univ Marche, Ancona, Italy
Somani, BK:
NHS Trust, Univ Hosp Southampton, Dept Urol, Southampton, England
Chew, B:
Univ British Columbia, Dept Urol, Vancouver, BC, Canada
Tailly, T:
Univ Hosp Ghent, Dept Urol, Ghent, Belgium
Keat, WOL:
Penang Gen Hosp, Dept Urol, George Town, Malaysia
Teoh, JY:
Chinese Univ Hong Kong, Fac Med, SH Ho Urol Ctr, Dept Surg, Hong Kong, Peoples R China
Emiliani, E:
Univ Autonoma Barcelona, Fdn Puigvert, Urol Dept, Barcelona, Spain
Chai, CA:
Univ Malaya, Dept Surg, Urol Unit, Kuala Lumpur, Malaysia
Galosi, AB:
Polytech Univ Marche, Urol Unit, Azienda Osped Univ Marche, Ancona, Italy
Ragoori, D:
Asian Inst Nephrol & Urol, Dept Urol, Hyderabad, Telangana, India
Tanidir, Y:
Marmara Univ, Dept Urol, Sch Med, Istanbul, Turkiye
Hamri, SB:
King Saud Bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, Div Urol, Minist Natl Guard Hlth Affairs,Dept Surg, Riyadh, Saudi Arabia
Gadzhiev, N:
St Petersburg State Med Univ, Endourol Dept, St Petersburg, Russia
Traxer, O:
Sorbonne Univ, Tenon Hosp, AP HP, Dept Urol, Paris, France
Gauhar, V:
Ng Teng Fong Gen Hosp, Dept Urol, Singapore, Singapore
hybrid, All Open Access, Hybrid Gold
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