Simultaneous Bilateral Endoscopic Surgery (SBES): Is It Ready for Prime Time?

Proietti, Silvia; Pavia, Maria Pia; Rico, Luís; Basulto-Martínez, Mario; Yeow, Yuyi; Contreras, Pablo Nicolas; Galosi, Andrea Benedetto; Gaboardi, Franco; Giusti, Guido

doi:10.1089/end.2022.0013

Cited by 4 publications

(8 citation statements)

References 26 publications

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“…In our study, we present data on the feasibility of SBES in the prone split-leg position for the first time. Our initial analysis includes 72 cases of SBES in this position, with a bilateral SFR of 70.83%, which is comparable to that reported for supine SBES [8,10,12].…”

Section: Discussionsupporting

confidence: 64%

“…In our study, 15 out of 72 cases developed febrile UTI after surgery and required additional intravenous antibiotics, but no urosepsis occurred. The higher incidence of infectious complications in our analysis, compared to other studies [8,12], may be attributed to the larger stone load and longer operative times in our cohort. Prolonged operation duration has been recognized as a risk factor for postoperative UTI [22][23][24][25].…”

Section: Discussioncontrasting

confidence: 50%

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Feasibility of Simultaneous Bilateral Endoscopic Surgery in Prone Split-Leg Position for Bilateral Upper Urinary Tract Calculi: A Pilot Study

Jiang,

Sheng,

Zhang

et al. 2024

Urol Int

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Introduction We explored the viability of simultaneous bilateral endoscopic surgery (SBES) in the prone split-leg position for managing bilateral calculi. Methods We retrospectively reviewed 72 patients who underwent SBES, with procedures involving ureteroscopy (URS) and contralateral percutaneous nephrolithotomy (PNL) simultaneously, in prone split-leg position. Results Operative times averaged 109.38±30.76 minutes, with an average hospital stay of 7.79±3.78 days. Bilateral stone-free rate (SFR) was 70.83%, while URS and PNL demonstrated comparable unilateral SFR (83.33% and 79.17%, respectively). Receiver operating characteristics (ROC) curves for predicting unilateral residual fragments yielded an area under the curve (AUC) of 0.84 (URS) and 0.81 (PNL) with respective cut-off values of stone diameter of 11.55 mm and 23.52 mm. 57 (79.17%) and 15 (20.83%) patients encountered grade 0-1/2 complications, with no severe complications (grade 3-5) recorded. No significant changes in blood count or renal function were observed post-SBES. Conclusions SBES in the prone split-leg position is a viable option for managing bilateral upper-tract urolithiasis. Larger-scale studies are needed to further assess safety and efficacy in various positions.

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Section: Discussionsupporting

confidence: 64%

Section: Discussioncontrasting

confidence: 50%

Feasibility of Simultaneous Bilateral Endoscopic Surgery in Prone Split-Leg Position for Bilateral Upper Urinary Tract Calculi: A Pilot Study

Jiang,

Sheng,

Zhang

et al. 2024

Urol Int

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“…In one of the last works of S. Proietti et al [47] from 2022 focused on simultaneous bilateral ECIRS, a prospective analysis of 101 patients with bilateral nephrolithiasis was conducted. The results of the study showed high efficiency of simultaneous bilateral application of the ECIRS method: SFR = 81.1 %, with the frequency of complications (according to the Clavien-Dindo classification): 7.9 %, 9.9 % and 1.0 % -Grade I, Grade II and Grade III, respectively.…”

Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

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“…Bilateral renal stones pose a unique challenge for patients and surgeons alike, and while there are no guidelines on the best approach, in recent times RIRS has made the management of these stones more accessible. In fact, current endourological intervention for kidney stone disease is so advanced that endoscopic combined intrarenal surgery and simultaneous bilateral endoscopic surgery are now considered the forerunners for a tailored and personalized approach in managing such patients [14] , [15] . However, large-volume multicenter real-world data are lacking on how bilateral surgical intervention by RIRS impacts SFR and surgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…As a matter of fact, in some circumstances, we decided to stop surgery earlier due to concerns for sepsis or prolonged operation time. Therefore, judicious use of the surgical time is one of the cornerstones of a safe SSB-RIRS, and in the presence of preoperative predictors of prolonged surgical time (eg, bilateral and large stone burden, and anomalous kidneys), staged procedures or a simultaneous RIRS on one side and percutaneous nephrolithotripsy on the other side [15] should be planned to minimize morbidity.…”

Section: Discussionmentioning

confidence: 99%

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

Traxer

Ragoori

et al. 2023

European Urology Open Science

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Simultaneous Bilateral Endoscopic Surgery (SBES): Is It Ready for Prime Time?

Cited by 4 publications

References 26 publications

Feasibility of Simultaneous Bilateral Endoscopic Surgery in Prone Split-Leg Position for Bilateral Upper Urinary Tract Calculi: A Pilot Study

Feasibility of Simultaneous Bilateral Endoscopic Surgery in Prone Split-Leg Position for Bilateral Upper Urinary Tract Calculi: A Pilot Study

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

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

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