Do Anesthesia Methods in Retrograde Intrarenal Surgery Make Difference Regarding the Success of Ureteral Access and Surgical Outcomes?

Öztekin, Ünal; Caniklioğlu, Mehmet; Selmï, Volkan; Kantekin, Çiğdem Ünal; Ataç, Fatih; Gürel, Abdullah; Sarı, Sercan

doi:10.1089/lap.2019.0548

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…Comparing Clavien-Dindo grade I complications, we noted no statistically significant difference between NA and GA groups (OR: 0.74 95% CI: 0.52, 1.06 I 2 = 13% p = 0.10; Figure 5 ). On sensitivity analysis, exclusion of the studies of Kwon et al ( 22 ) (OR: 0.70 95% CI: 0.53, 0.94 I 2 = 3% p = 0.02) and Oztekin et al ( 25 ) (OR: 0.69 95% CI: 0.52, 0.90 I 2 = 0% p = 0.007) changed the significance of the results demonstrating reduced complications with NA. Subgroup analysis based on study type revealed no difference in complications between the two groups for RCTs but reduced risk of complications with NA in non-RCTs.…”

Section: Resultsmentioning

confidence: 93%

“…Eight studies were RCTs while the remaining were prospective or retrospective cohort studies. Four studies compared combined epidural and spinal anesthesia with GA while seven studies compared only spinal anesthesia with GA. Two studies ( 19 , 25 ) conducted a three-arm analysis comparing epidural vs. spinal vs. GA. For the meta-analysis, we combined data of epidural and spinal groups of these two studies into a single group. However, for subgroup analysis based on NA type, we used data of spinal anesthesia from these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen articles were retrieved for full-text analysis of which one was excluded as it compared peripheral nerve block with GA. Finally, a total of 13 studies were included in this systematic review and metaanalysis (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”

Section: Details Of Included Studiesmentioning

confidence: 99%

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Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

2022

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BackgroundThe current review aimed to assess if the outcomes of retrograde intrarenal surgery (RIRS) differ with neuraxial anesthesia (NA) or general anesthesia (GA).MethodsThe databases of PubMed, Embase, CENTRAL, ScienceDirect, and Google Scholar were searched up to 3rd December 2021 for randomized controlled trials (RCTs) and observational studies comparing outcomes of RIRS with NA or GA.ResultsThirteen studies involving 2912 patients were included. Eight were RCTs while remaining were observational studies. Meta-analysis revealed that stone free status after RIRS did not differ with NA or GA (OR: 0.99 95% CI: 0.77, 1.26 I2 = 10% p = 0.91). Similarly, there was no difference in operation time (MD: −0.35 95% CI: −4.04, 3.34 I2 = 89% p = 0.85), 24 h pain scores (MD: −0.36 95% CI: −0.96, 0.23 I2 = 95% p = 0.23), length of hospital stay (MD: 0.01 95% CI: −0.06, 0.08 I2 = 35% p = 0.78), Clavien-Dindo grade I (OR: 0.74 95% CI: 0.52, 1.06 I2 = 13% p = 0.10), grade II (OR: 0.70 95% CI: 0.45, 1.07 I2 = 0% p = 0.10) and grade III/IV complication rates (OR: 0.78 95% CI: 0.45, 1.35 I2 = 0% p = 0.37) between NA and GA. Except for grade I complications, the results did not change on subgroup analysis based on study type and NA type.ConclusionOur results suggest that NA can be an alternative to GA for RIRS. There seem to be no difference in the stone-free rates, operation time, 24-h pain scores, complication rates, and length of hospital stay between NA and GA for RIRS. Considering the economic benefits, the use of NA may be preferred over GA while taking into account patient willingness, baseline patient characteristics, and stone burden.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021295407.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

2022

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“…In our study, spinal and epidural anesthesia were generally used for RIRS. There are studies comparing three types of anesthesia in RIRS (18,19). The appropriate anesthesia method is chosen according to the surgeon, anesthesiologist and patient features.…”

Section: Methodsmentioning

confidence: 99%

Multikalisiyel ve Multiple Böbrek Taşlarının Tedavisinde Retrograd İntrarenal Cerrahi Deneyimimiz

Sarı

Selmï

Caniklioğlu

et al. 2020

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Multiple kidney stones are seen in 20-25% of the patients. Treatment of multiple kidney stones is challenging.Retrograde intrarenal surgery is used in the treatment of multiple kidney stones. Success is lower than the single stones of the same size. We aimed to report our retrograde intrarenal surgery experience in the treatment of multi-caliceal and multiple kidney stones. Material and Methods: After approval of local ethics committee, patient data between 01.01.2014-01.01.2019 were retrospectively analyzed. Patients who had undergone retrograde intrarenal surgery for multi-caliceal and multiple kidney stones were included in our study. Demographic, intraoperative and postoperative data and complications were recorded. Results: Forty-three patients were included in our study. The mean stone size was 13.69±6.21 mm. Mean stone volume was 972.48 ± 905.24 mm 3 . Mean Hounsfield unit was 1128.26±317.91 HU. The mean operation time was 51.97±20.18 minutes. Thirty-two patients were stone free. Postoperative complications were seen in four patients. Mucosal injury was observed in one patient and urinary tract infection was observed in three patients. Conclusion: Multi-caliceal and multiple kidney stone treatment is challenging for urologists. There are various treatment methods. Retrograde intrarenal surgery is a safe and efficient alternative for the treatment of multi-caliceal and multiple kidney stones. Prospective and larger cohort studies are needed. Amaç: Multiple böbrek taşları % 20-25 hastada görülmektedir. Tedavisi zordur. Retrograd intrarenal cerrahi multiple böbrek taşı tedavisinde kullanılmaktadır. Başarı aynı boyuttaki normal taşlara göre düşüktür. Biz çalışmamızda kliniğimizdeki multiple taş tedavisinde retrograd intrarenal cerrahi deneyimimizi sunmayı amaçladık. Gereç ve Yöntemler: Lokal etik kurul onayı alındıktan sonra 01.01.2014-01.01.2019 arası hasta verileri retrospektif olarak tarandı. Multikaliseal ve multiple böbrek taşı için retrograd intrarenal cerrahi yapılan hastalar çalışmaya alındı. Onsekiz yaş altındaki hastalar çalışmadan çıkarıldı. Demografik, intraoperatif, postoperatif veriler ve komplikasyonlar kaydedildi. Bulgular: Çalışmaya 43 hasta alındı. Taş boyutu ortalama 13.69±6.21 mm idi. Taş volümü ortalama 972.48 ± 905.24 mm 3 , Hounsfield ünitesi ortalama 1128.26±317.91 HU idi. Ortalama operasyon zamanı 51.97±20.18 dakikaydı. Taşsızlık 32 hastada sağlandı. Postoperatif komplikasyonlar dört hastada görüldü. Bir hastada mukozal yaralanma, üç hastada idrar yolu enfeksiyonu izlendi. Sonuç: Multikaliseal ve multiple böbrek taş tedavisi ürologlar için zorludur. Çeşitli tedavi yöntemleri mevcuttur. Retrograd intrarenal cerrahi güvenli ve etkin bir alternatiftir. Prospektif ve yüksek hasta sayılı çalışmalara ihtiyaç vardır.

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Comparison of retrograde intrarenal surgery under regional versus general anaesthesia: A systematic review and meta-analysis

Luo

Jiao

Zhao

et al. 2020

International Journal of Surgery

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Do Anesthesia Methods in Retrograde Intrarenal Surgery Make Difference Regarding the Success of Ureteral Access and Surgical Outcomes?

Cited by 6 publications

References 22 publications

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

Multikalisiyel ve Multiple Böbrek Taşlarının Tedavisinde Retrograd İntrarenal Cerrahi Deneyimimiz

Comparison of retrograde intrarenal surgery under regional versus general anaesthesia: A systematic review and meta-analysis

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