Результаты исследований: Научные публикации в периодических изданиях › статья › Рецензирование
Improving Outcomes of Same-sitting Bilateral Flexible Ureteroscopy for Renal Stones in Real-world Practice-Lessons Learnt from Global Multicenter Experience of 1250 Patients. / Castellani, Daniele; Traxer, Olivier; Ragoori, Deepak; Galosi, Andrea Benedetto; De Stefano, Virgilio; Gadzhiev, Nariman; Tanidir, Yiloren; Inoue, Takaaki; Emiliani, Esteban; Hamri, Saeed Bin; Lakmichi, Mohamed Amine; Vaddi, Chandra Mohan; Heng, Chin Tiong; Soebhali, Boyke; More, Sumit; Sridharan, Vikram; Gökce, Mehmet Ilker; Tursunkulov, Azimdjon N; Ganpule, Arvind; Pirola, Giacomo Maria; Naselli, Angelo; Aydin, Cemil; Ramón de Fata Chillón, Fernando; Mendoza, Catalina Solano; Candela, Luigi; Chew, Ben Hall; Somani, Bhaskar Kumar; Gauhar, Vineet.
в: European Urology Open Science, Том 52, 06.2023, стр. 51-59.Результаты исследований: Научные публикации в периодических изданиях › статья › Рецензирование
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TY - JOUR
T1 - Improving Outcomes of Same-sitting Bilateral Flexible Ureteroscopy for Renal Stones in Real-world Practice-Lessons Learnt from Global Multicenter Experience of 1250 Patients
AU - Castellani, Daniele
AU - Traxer, Olivier
AU - Ragoori, Deepak
AU - Galosi, Andrea Benedetto
AU - De Stefano, Virgilio
AU - Gadzhiev, Nariman
AU - Tanidir, Yiloren
AU - Inoue, Takaaki
AU - Emiliani, Esteban
AU - Hamri, Saeed Bin
AU - Lakmichi, Mohamed Amine
AU - Vaddi, Chandra Mohan
AU - Heng, Chin Tiong
AU - Soebhali, Boyke
AU - More, Sumit
AU - Sridharan, Vikram
AU - Gökce, Mehmet Ilker
AU - Tursunkulov, Azimdjon N
AU - Ganpule, Arvind
AU - Pirola, Giacomo Maria
AU - Naselli, Angelo
AU - Aydin, Cemil
AU - Ramón de Fata Chillón, Fernando
AU - Mendoza, Catalina Solano
AU - Candela, Luigi
AU - Chew, Ben Hall
AU - Somani, Bhaskar Kumar
AU - Gauhar, Vineet
N1 - © 2023 The Authors.
PY - 2023/6
Y1 - 2023/6
N2 - BACKGROUND: Bilateral kidney stones are commonly treated in staged procedures.OBJECTIVE: To evaluate outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones.DESIGN SETTING AND PARTICIPANTS: 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.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: 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.RESULTS AND LIMITATIONS: 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.CONCLUSIONS: SSB-RIRS is an effective treatment with an acceptable complication rate in selected patients with kidney stones.PATIENT SUMMARY: 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.
AB - BACKGROUND: Bilateral kidney stones are commonly treated in staged procedures.OBJECTIVE: To evaluate outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones.DESIGN SETTING AND PARTICIPANTS: 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.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: 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.RESULTS AND LIMITATIONS: 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.CONCLUSIONS: SSB-RIRS is an effective treatment with an acceptable complication rate in selected patients with kidney stones.PATIENT SUMMARY: 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.
U2 - 10.1016/j.euros.2023.03.018
DO - 10.1016/j.euros.2023.03.018
M3 - Article
C2 - 37284041
VL - 52
SP - 51
EP - 59
JO - European Urology Open Science
JF - European Urology Open Science
SN - 2666-1691
ER -
ID: 116247561