A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone

Berardinelli, Francesco; Proietti, Silvia; Cindolo, Luca; F, Pellegrini; Peschechera, Roberto; Hennessey, Derek; Dalpiaz, Orietta; Schips, Luigi; Giusti, Guido

doi:10.1590/s1677-5538.ibju.2015.0528

Cited by 35 publications

(18 citation statements)

References 28 publications

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“…The overall complication rate in the HD group was 21.1%, which is consistent with overall, nondensityspecific rates reported in the literature (8%-24.9%). 19,20 In this study, even though the intraoperative complication rate in the HD group was slightly higher than in the LD group, the difference was not statistically significant. The most common intraoperative complication in both groups was failure to reach the stone.…”

Section: Discussioncontrasting

confidence: 60%

“…The overall intraoperative complication rate in the HD group (8.8%) is also comparable to overall, nondensity-specific rates reported in the literature (7%-30%). 19,20 A single-center retrospective study reported that most intraoperative complications were minor, with insignificant clinical consequences. 21 This finding is in line with our results.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis

Başataç

Özman

Akgül

et al. 2022

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: The aim of the study was to evaluate the impact of stone density on operative complication rates in retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 473 consecutive patients undergoing RIRS for the treatment of upper tract urinary stones were included. To adjust for baseline confounders, one-to-one propensity score matching was performed. After matching, the patients were divided into two groups according to stone density (low density [LD] group, £970 Hounsfield unit [HU]; high density [HD] group, >970 HU). The patients' demographics, stone-related features, stone-free rates, and intraoperative and postoperative complication rates were compared between the groups. The primary objective was to evaluate whether the intraoperative and postoperative complication rates were higher in patients whose stone density was greater than 970 HU. Results: After propensity score matching, 170 of 210 LD and 170 of 263 HD patients undergoing RIRS were included. The baseline characteristics did not differ significantly between the groups. There were no significant differences between LD and HD patients with respect to intraoperative (5.9% and 8.8%, respectively; P = .29), postoperative (10.6% and 15.3%, respectively; P = .14), and overall complication rates (15.2% and 21.1%, respectively; P = .16). Stone-free status was achieved in 143 patients (84.1%) in the LD group and 148 patients (87%) in the HD group; the difference was not statistically significant (P = .27). Conclusion: Our results show that RIRS is a safe and effective minimally invasive procedure for the treatment of upper urinary tract stones, even in HD stones.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis

Başataç

Özman

Akgül

et al. 2022

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…According to size, composition, and localization of the stone, stone-free rates vary from 65–100%. Complications occur in 0–20% 5, 45, 46, 48, 49 .…”

Section: Managing Urolithiasismentioning

confidence: 99%

Recent advances in understanding and managing urolithiasis

Strohmaier

2016

F1000Res

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During the last few years, there has been relevant progress in both understanding and managing urolithiasis. Our knowledge of stone formation has changed; although the importance of urine biochemistry was questioned by several investigators years ago, the decisive role of cellular processes (induced by oxidative stress) and the renal papilla has only recently been generally accepted as the most important step in stone formation. For calcium oxalate urolithiasis, the formation of papillary calcifications plays a key role and is of prognostic relevance. Further research has to concentrate on these aspects of preventing urolithiasis. Stone prevention (metaphylaxis) is a major issue when considering the burden it places on healthcare systems. An effective metaphylaxis could lower the cost of stone therapy significantly. For uric acid urolithiasis, so far there is only preliminary information available showing that papillary plaques are not as important as they are in calcium oxalate urolithiasis. Concerning stone management, endourology has improved stone therapy significantly during the last few years. Morbidity decreased and success (stone-free) rates increased. Therefore, the indications for extracorporeal shockwave lithotripsy (ESWL) narrowed. ESWL, however, still has its place in stone therapy. There is not one single treatment modality that is equally effective for all situations. It is important to observe the differential indications for different stones depending on size, localization, and composition.

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“…1 Increased use of flexible ureterorenoscopy and holmium laser has made treatment possible of upper urinary system stones of various sizes with high stonefree rates, low morbidity, short hospital stay, and high patient comfort. 2 With these advantages, retrograde intrarenal surgery (RIRS) has become one of the most important current treatment options applied to upper urinary system stones <2 cm. 3 In the European Urology Association (EUA) guidelines, it is shown together with shockwave lithotripsy (SWL) as an alternative treatment to percutaneous nephrolithotomy (PNL) for stones >2 cm.…”

Section: Introductionmentioning

confidence: 99%

“…In selected cases with negative factors such as low success of SWL in lower pole stones, 4 the difficulty of applying SWL and PNL in obese patients, pregnancy or coagulopathy, RIRS has become the primary treatment choice for stones >2 cm. 2 Although the treatment area of RIRS has broadened to this extent and it is preferred in many centres because of the low morbidity rates, there are also complications of RIRS, which cannot be ignored. 5 The most frequently encountered complication of this procedure is postoperative infection and despite prophylactic antibiotic treatment, incidence has been reported in literature of 1.7-18.8%.…”

Section: Introductionmentioning

confidence: 99%