Статья

Improving Outcomes of Same-sitting Bilateral Flexible Ureteroscopy for Renal Stones in Real-world Practice—Lessons Learnt from Global Multicenter Experience of 1250 Patients

Daniele CastellaniUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, ItalyOlivier TraxerDepartment of Urology AP-HP, Sorbonne University, Tenon Hospital, Paris, FranceDeepak RagooriDepartment of Urology, Asian Institute of Nephrology & Urology, Irram Manzil Colony, Hyderabad, Telangana, IndiaAndrea Benedetto GalosiUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, ItalyVirgilio De StefanoUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, ItalyNariman GadzhievDepartment of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, RussiaYılören TanıdırDepartment of Urology, School of Medicine, Marmara University, İstanbul, TurkeyTakaaki InoueDepartment of Urology, Hara Genitourinary Private Hospital, Kobe University, Kobe, JapanEsteban EmilianiDepartment of Urology, Fundacion Puigvert, Autónomos University of Barcelona, Barcelona, SpainSaeed Bin HamriDivision of Urology, Department of Surgery, Ministry of the National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaMohamed Amine LakmichiDepartment of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, MoroccoChandra Mohan VaddiChin Tiong HengDepartment of Urology, Ng Teng Fong General Hospital, Singapore, SingaporeBoyke SoebhaliDepartment of Urology, Abdul Wahab Sjahranie Hospital, Medical Faculty Mulawarman University, Samarinda, IndonesiaSumit MoreVikram SridharanMehmet Ilker GökceDepartment of Urology, Ankara University, School of Medicine, Ankara, TurkeyAzimdjon TursunkulovUrology Division, AkfaMedline Hospital, Tashkent, UzbekistanArvind GanpuleDepartment of Urology, Muļjibhai Patel Urological Hospital, Nadiad, Gujarat, IndiaGiacomo Maria PirolaUrology Department, San Giuseppe Hospital, IRCCS Multimedica, Multimedica Group, Milan, ItalyAngelo NaselliUrology Department, San Giuseppe Hospital, IRCCS Multimedica, Multimedica Group, Milan, ItalyCemil AydınDepartment of Urology, Hitit University, School of Medicine, Çorum, TurkeyF. Ramón de FataDepartment of Urology, Clinica Universidad de Navarra, Madrid, SpainCatalina Solano MendozaDepartment of Endourology, Uroclin S.A.S, Medellín, ColombiaLuigi CandelaDepartment of Urology AP-HP, Sorbonne University, Tenon Hospital, Paris, FranceBen H. ChewDepartment of Urology, University of British Columbia, Vancouver, CanadaBhaskar SomaniVineet GauharDepartment of Urology, Ng Teng Fong General Hospital, Singapore, Singapore

European Urology Open Sciencejournal2023en

ABI

Аннотация

Bilateral kidney stones are commonly treated in staged procedures. To evaluate outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones. Data from adults who underwent bilateral RIRS in 21 centers were retrospectively reviewed (from January 2015 to June 2022). The inclusion criteria were unilateral/bilateral symptomatic bilateral stone(s) of any size/location in both kidneys and bilateral stones on follow-up with symptom/stone progression. Stone-free rate (SFR) was defined as absence of any fragment >3 mm at 3 mo. Continuous variables are presented as medians and 25–75th percentiles. A multivariable logistic regression analysis was performed to evaluate independent predictors of sepsis and bilateral SFR. A total of 1250 patients were included. The median age was 48.0 (36–61) yr. Of the patients, 58.2% were prestented. The median stone diameter was 10 mm on both sides. Multiple stones were present in 45.3% and 47.9% of the left and right kidneys, respectively. Surgery was stopped in 6.8% of cases. The median surgical time was 75.0 (55–90) min. Complications were transient fever (10.7%), fever/infection needing prolonged stay (5.5%), sepsis (2%), and blood transfusion (1.3%). Bilateral and unilateral SFRs were 73.0% and 17.4%, respectively. Female (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.18–7.49, p = 0.02), no antibiotic prophylaxis (OR 5.99, 95% CI 2.28–15.73, p < 0.001), kidney anomalies (OR 5.91, 95% CI 1.96–17.94, p < 0.001), surgical time ≥100 min (OR 2.86, 95% CI 1.12–7.31, p = 0.03) were factors associated with sepsis. Female (OR 1.88, 95% CI 1.35–2.62, p < 0.001), bilateral prestenting (OR 2.16, 95% CI 1.16–7.66, p = 0.04), and the use of high-power holmium:YAG laser (OR 1.63, 95% CI 1.14–2.34, p < 0.01) and thulium fiber laser (OR 2.50, 95% CI 1.32–4.74, p < 0.01) were predictors of bilateral SFR. Limitations were retrospective study and no cost analysis. SSB-RIRS is an effective treatment with an acceptable complication rate in selected patients with kidney stones. In this large multicenter study, we looked at outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones in a large cohort. We found that SSB-RIRS was associated with acceptable morbidity and good stone clearance after a single session.

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Темы

Kidney Stones and Urolithiasis Treatments Dialysis and Renal Disease Management Ureteral procedures and complications

Идентификаторы

DOI: 10.1016/j.euros.2023.03.018

Цитирования и источники

Цитирований: 5 Использованных источников: 30

Показатели — AkademScholar