A comparative study of percutaneous nephrolithotomy in supine position and endoscopic combined intrarenal surgery with flexible instrument

Rosa, I. Nuño de la; Palmero, J.L.; Miralles, J.; J, Pastor; Benedicto, Antonio

doi:10.1016/j.acuroe.2013.06.003

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…ECIRS is a new useful approach for the treatment of large renal stones . We have regularly carried out ECIRS in the modified Valdivia position for the treatment of large renal stones since April 2010 because of studies showing the effectiveness of ECIRS for the treatment of large renal stones …”

Section: Discussionmentioning

confidence: 99%

“…11,13,14 We have regularly carried out ECIRS in the modified Valdivia position for the treatment of large renal stones since April 2010 12 because of studies showing the effectiveness of ECIRS for the treatment of large renal stones. [18][19][20] Recent studies investigating postoperative SIRS after PCNL have reported the following risk factors: multiple access tracts, 21 high stone burden, 21,22 female sex, 4 positive preoperative urine culture, 23,24 positive intraoperative pelvic urine and stone culture, [23][24][25] history of UTI, 22 operation time, 26 and paraplegia. 6 In addition, the Clinical Research Office of the Endourological Society PCNL Study Group reported the risk factors of postoperative fever (>38.5°C) to be positive urine culture, staghorn calculi, preoperative nephrostomy, a lower patient age and diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

et al. 2016

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The number of involved calyces larger than four, stone surface area >500 mm(2) and a history of febrile urinary tract infection independently predicted the development of systemic inflammation response syndrome after endoscopic combined intrarenal surgery. This is the first study to identify the independent predictors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

et al. 2016

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“…[1][2][3] The use of flexible ureteroscopy (FURS) as an alternative to PCNL in the treatment of large (>2 cm) renal stones was shown to be an effective modality in previous reports.…”

Section: Introductionmentioning

confidence: 99%

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Hamed

Elmoghazy

Mohamed

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the stone hardness in predicting the need for single or two sessions of retrograde intrarenal surgery (RIRS) for renal pelvis stones of 2-3 cm in size. Material and methods:Ninety-six patients (64 male and 32 female) with only renal stones (2.5±0.3 cm) underwent RIRS using flexible 7.5 Fr ureteroscope (FURS). The stone hardness was evaluated by preoperative non-contrast computed tomography (NCCT). The patients were divided into two groups based on stone hardness: Group I (n=54) (hard stones -Hounsfield Unit (HU) >1000) and group II (n=42) (not hard stone -HU <1000). The stone-free rate, the operative time, any intra or postoperative complications and the need for second sessions of RIRS were evaluated.Results: All stones were successfully accessed. Intraoperative complications were not reported. The initial stone-free rate was 40% in Group I and 95% in Group II after a single session (p= 0.01). A second session FURS was needed in 32 cases of Group I (40%) where postoperative CT showed significant residual stone fragments of 6±2 mm, and stone-free rate up to 100 percent. On the contrary only 2 cases from Group II underwent second session FURS (p= 0.01). The operative times were 75±15 minutes in Group I and 55±13 minutes in Group II (p<0.01). Six patients (4 in group I and 2 in group II) had postoperative high-grade fever (Clavien Grade II). Conclusion:Stone hardness had a significant impact on the decision of performing single versus two sessions of FURS for renal pelvic stones of 2-3 cm rather than the stone size alone.

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“…Following a complete search of the literature with the inclusion and exclusion criteria, 21 full-text studies were identiﬁed, and a total of 5 studies [ 9 , 10 , 12 , 13 , 17 ] with a total of 546 patients (ECIRS/mini-ECIRS, N = 277; PCNL/mini-PCNL, N = 269) were included in the analysis. The Nuño de la Rosa study compared standard PCNL with standard-ECIRS [ 13 ], whereas the other 4 studies compared mini-PCNL with mini-ECIRS [ 9 , 10 , 12 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported aggregate stone surface area (mm 2 ) and/or largest diameter (mm) as means ± standard deviation, and one study [ 13 ] reported medians with corresponding ranges (lower bound (LB) to upper bound (UB)). In the study that reported stone diameter as a median (m(LBUB)), the means were determined as being equal to the median if the sample size of both arms was ≥70 [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

The Safety and Efficacy of Endoscopic Combined Intrarenal Surgery (ECIRS) versus Percutaneous Nephrolithotomy (PCNL): A Systematic Review and Meta-Analysis

Abdullatif

Sur

Abdullatif

et al. 2022

Advances in Urology

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Purpose. Our aim is to evaluate the safety and efficacy of endoscopic combined intrarenal surgery compared to percutaneous nephrolithotomy to guide practitioners and inform guidelines. Materials and Methods. A detailed database search was performed in PubMed, OVID, Scopus, and Web of Science in October 2021 to identify articles pertaining to ECIRS published between 2001 and 2021. Results. Four nonrandomized comparative studies and one RCT were identified, yielding five studies with a total of 546 patients (ECIRS/mini-ECIRS, n = 277; PCNL/mini-PCNL, n = 269). Subjects in these five studies met the predefined inclusion criteria established by two reviewers (J.E.A. and R.L.S.) and were therefore eligible for analysis. The results demonstrated that ECIRS was associated with a higher SFR (OR: 4.20; 95% CI: 2.79, 6.33; p < 0.00001 ), fewer complications (OR: 0.63; 95% CI: 0.41, 0.97; p = 0.04 ), and a shorter hospital stay (WMD: −1.27; 95% CI: −1.55, −0.98; p < 0.00001 ) when compared to PCNL. There were no statistically significant differences in blood transfusions (OR: 0.45; 95% CI: 0.12, 1.68; p = 0.24 ), operative time (SMD: −1.05; 95% CI: −2.42, 0.31; p = 0.13 ), or blood loss (SMD: −1.10; 95% CI: −2.46, 0.26; p = 0.11 ) between ECIRS and PCNL. Conclusions. ECIRS may be a more suitable approach for the surgical management of large and complex kidney stones currently indicating PCNL due to its superior efficacy with comparable surgical time and complication rate, though it is thought that a lack of resources and properly trained personnel may preclude ECIRS from becoming the standard. It is our impression that ECIRS may become the preferred technique in the endourologic community corresponding to the evolutionary sequence of percutaneous stone surgery.

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A comparative study of percutaneous nephrolithotomy in supine position and endoscopic combined intrarenal surgery with flexible instrument

Cited by 13 publications

References 24 publications

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

The Safety and Efficacy of Endoscopic Combined Intrarenal Surgery (ECIRS) versus Percutaneous Nephrolithotomy (PCNL): A Systematic Review and Meta-Analysis

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