M Cepeda1, J H Amón2, J A Mainez2, V Rodríguez2, D Alonso2, J M Martínez-Sagarra2. 1. Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España. Electronic address: marcoscepedadelgado@yahoo.es. 2. Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.
Abstract
OBJECTIVES: The objectives of this prospective study are to present our experience with retrograde intrarenal surgery (RIRS), and to analyze its results and complications. MATERIAL AND METHODS: 150 patients with renal stones were treated with RIRS. 111 cases showed single stones whilst multiple stones were observed in 39 cases. The mean size was 19.12mm (r: 5-74). Success rate was defined as the absence of residual stones or the presence of fragments ≤2mm. RESULTS: in 21 (14%) patients RIRS could not be performed on first attempt because it was impossible to place the ureteral access sheath. The immediate success rate was 85.7%, and 91.6% at three months later. The average operating time was 85min (r: 25-220). Postoperative complications were observed in 22 cases (14.6%), although most of them were classified as Clavien 1 and 2 (19 cases), and only 2% (3 cases) showed Clavien 4 complications (sepsis requiring admission in the intensive care unit). 10 patients underwent a second procedure in order to complete the treatment. Thus, the number of procedures per patient was 1.06. There were no late complications. CONCLUSIONS: the treatment of renal stones with flexible ureteroscopy using the ureteral access sheath shows a high successful rate with a low complication rate. In order to define its indication more precisely, randomized studies comparing RIRS with minimally invasive percutaneous nephrolithotomy procedures (miniperc and microperc) would be necessary.
OBJECTIVES: The objectives of this prospective study are to present our experience with retrograde intrarenal surgery (RIRS), and to analyze its results and complications. MATERIAL AND METHODS: 150 patients with renal stones were treated with RIRS. 111 cases showed single stones whilst multiple stones were observed in 39 cases. The mean size was 19.12mm (r: 5-74). Success rate was defined as the absence of residual stones or the presence of fragments ≤2mm. RESULTS: in 21 (14%) patients RIRS could not be performed on first attempt because it was impossible to place the ureteral access sheath. The immediate success rate was 85.7%, and 91.6% at three months later. The average operating time was 85min (r: 25-220). Postoperative complications were observed in 22 cases (14.6%), although most of them were classified as Clavien 1 and 2 (19 cases), and only 2% (3 cases) showed Clavien 4 complications (sepsis requiring admission in the intensive care unit). 10 patients underwent a second procedure in order to complete the treatment. Thus, the number of procedures per patient was 1.06. There were no late complications. CONCLUSIONS: the treatment of renal stones with flexible ureteroscopy using the ureteral access sheath shows a high successful rate with a low complication rate. In order to define its indication more precisely, randomized studies comparing RIRS with minimally invasive percutaneous nephrolithotomy procedures (miniperc and microperc) would be necessary.
Authors: María Rodríguez-Monsalve Herrero; Steeve Doizi; Etienne Xavier Keller; Vincent De Coninck; Olivier Traxer Journal: Asian J Urol Date: 2018-06-22