Yonghan Peng1, Ling Li1, Wei Zhang1, Qi Chen2, Min Liu1, Xiaolei Shi1, Xiaofeng Gao1, Yinghao Sun1. 1. 1 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, PR China . 2. 2 Department of Health Statistics, Faculty of Health Service, Second Military Medical University , Shanghai, PR China .
Abstract
PURPOSE: This study aimed to compare the effectiveness and safety of single-stage bilateral and unilateral retrograde intrarenal surgery (RIRS) for treatment of patients with renal stones. PATIENTS AND METHODS: Patients undergoing single-stage bilateral RIRS for renal stones between January 2011 and April 2014 were retrospectively reviewed and matched to patients undergoing unilateral RIRS at a 1:1 ratio by the propensity score based on age, sex, body mass index, American Society of Anesthesiologists classification, stone burden, and stone location (involvement of the lower calix or not). Main outcome measures were stone-free rate per patient and per renal unit and RIRS-associated morbidity. RESULTS: Of 60 patients treated by single-stage bilateral RIRS, 59 patients were matched with patients treated by unilateral RIRS. Stone-free rates per patient for bilateral RIRS and unilateral RIRS were 84.7% and 91.5%, respectively (P=0.255). Median operative time (100 vs 65 min, P<0.001) and postoperative hospitalization (2 vs 1 d, P=0.011) was significantly longer for bilateral RIRS than unilateral RIRS. Median changes in hematocrit (1.3% vs 1.0%, P=0.964) and serum creatinine level (3 vs 2 μmol/L, P=0.716) were similar between bilateral and unilateral RIRS. The overall complication rate was slightly higher with bilateral RIRS (11.9% vs 8.5%, P=0.542). No serious RIRS-associated morbidities occurred in either group. CONCLUSION: Single-stage bilateral RIRS was as effective and safe as unilateral RIRS among propensity score-matched patients.
PURPOSE: This study aimed to compare the effectiveness and safety of single-stage bilateral and unilateral retrograde intrarenal surgery (RIRS) for treatment of patients with renal stones. PATIENTS AND METHODS: Patients undergoing single-stage bilateral RIRS for renal stones between January 2011 and April 2014 were retrospectively reviewed and matched to patients undergoing unilateral RIRS at a 1:1 ratio by the propensity score based on age, sex, body mass index, American Society of Anesthesiologists classification, stone burden, and stone location (involvement of the lower calix or not). Main outcome measures were stone-free rate per patient and per renal unit and RIRS-associated morbidity. RESULTS: Of 60 patients treated by single-stage bilateral RIRS, 59 patients were matched with patients treated by unilateral RIRS. Stone-free rates per patient for bilateral RIRS and unilateral RIRS were 84.7% and 91.5%, respectively (P=0.255). Median operative time (100 vs 65 min, P<0.001) and postoperative hospitalization (2 vs 1 d, P=0.011) was significantly longer for bilateral RIRS than unilateral RIRS. Median changes in hematocrit (1.3% vs 1.0%, P=0.964) and serum creatinine level (3 vs 2 μmol/L, P=0.716) were similar between bilateral and unilateral RIRS. The overall complication rate was slightly higher with bilateral RIRS (11.9% vs 8.5%, P=0.542). No serious RIRS-associated morbidities occurred in either group. CONCLUSION: Single-stage bilateral RIRS was as effective and safe as unilateral RIRS among propensity score-matched patients.
Authors: Oriol Angerri; Olga Mayordomo; Andres Koey Kanashiro; Felix Millan-Rodriguez; Francisco Maria Sanchez-Martin; Sung-Yo Cho; Eran Schreter; Mario Sofer; Saeed Bin-Hamri; Ahmed Alasker; Yiloren Tanidir; Tarik Emre Sener; Panagiotis Kalidonis; Joan Palou-Redorta; Esteban Emiliani Journal: Cent European J Urol Date: 2019-05-30