Which factors affect the hospital re-admission and re-hospitalization after flexible ureterorenoscopy for kidney stone?

Buldu, İbrahim; Tepeler, Abdülkadir; Karatag, Tuna; Özyuvalı, Ekrem; Elbir, Fatih; Yordam, Mustafa; Ünsal, Ali

doi:10.1007/s00345-015-1750-x

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…Similarly, in literature there are studies showing that a high ASA score is a risk factor for re-presentation after discharge and for postoperative infection. 7,14 Although some studies in literature have shown high rates of patients with a CCI score of >2 re-presenting after discharge and being readmitted to hospital, the CCI scores in the current study were similar in both groups. 14 When literature was examined in respect of the effect of a history of stone surgery on infective complications, there were seen to be studies showing that a history of stone surgery was a risk factor for infective complications; and there were studies where previous surgery was not seen as a risk factor.…”

Section: Discussioncontrasting

confidence: 45%

“…7,14 Although some studies in literature have shown high rates of patients with a CCI score of >2 re-presenting after discharge and being readmitted to hospital, the CCI scores in the current study were similar in both groups. 14 When literature was examined in respect of the effect of a history of stone surgery on infective complications, there were seen to be studies showing that a history of stone surgery was a risk factor for infective complications; and there were studies where previous surgery was not seen as a risk factor. 6,7 In the analysis of the current study, previous renal stone surgery was not found to be a risk factor for infective complications.…”

Section: Discussioncontrasting

confidence: 45%

“…In industrial societies, in particular, if the importance of return to work in the shortest possible time after surgery is taken into consideration, the short hospitalisation duration of RIRS is attractive. 1,14 However, in a procedure which has become so popular, it is important to predict which factors increase the risk of postoperative urinary system infection.…”

Section: Discussionmentioning

confidence: 99%

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Anaesthetic Management of Patients Undergoing Bariatric Surgery

Kaya

Bilgin

Cebeci

et al. 2019

J Coll Physicians Surg Pak

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Section: Discussioncontrasting

confidence: 45%

Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

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Anaesthetic Management of Patients Undergoing Bariatric Surgery

Kaya

Bilgin

Cebeci

et al. 2019

J Coll Physicians Surg Pak

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“…The representation rate to ED of at least 15% is consistent with other reports. 15 The retrospective nature of this study prevents any review of the pre-operative decision making but the large number of cases allows a snapshot of current Australian practice regarding URS. It could be argued that the results of those patients not reviewed were much better and that an active decision was made not to arrange any review, but there is no evidence in the hospital records that such decisions were made.…”

Section: Discussionmentioning

confidence: 99%

Ureterorenoscopic stone procedures have low success rates and poor post‐operative follow‐up: results from an Australian tertiary health service

Goel

Dat

Jackman

et al. 2023

ANZ Journal of Surgery

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BackgroundTo assess the results of ureterorenoscopy (URS) for upper tract urolithiasis in a contemporary Australian tertiary healthcare setting.MethodsHospital records of all URS stone procedures performed between January 2017 and December 2018 in a metropolitan service were retrospectively reviewed. Outcome measures including stone free rates, adherence to postoperative follow‐up and complications rates were recorded.Results385 patients (387 renal units) with mean age 53.8 (range 18–89) underwent URS for stones measuring between 2 and 27 mm (median 8 mm). 465 URS were performed with 1029 total procedures performed. 48.6% of operations were performed as day cases. Complications were recorded in 9% of the 465 URS cases with 42.9% of these Clavien II or more. The representation rate to our Emergency Departments was 15.4%. Only 49.1% (201) of patients had a follow‐up review with imaging to assess stone free rates. Of the 201 patients who underwent imaging, only 38.3% were stone free. Stone analysis was performed in 34.5%.ConclusionLess than half of all patients were reviewed despite undergoing expensive, time consuming surgery for a condition with a high recurrence rate. In agreement with recent publications stone‐free rates were low, with significant complications and representation rates. Stone surgery should be given the attention and resources equivalent to cancer surgery to improve results.Level of evidence2b.

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“…One of the primary metrics used to measure the outcome of RIRS is the stone-free rate (SFR). Residual stone fragments (RSF) of 4 mm or less after RIRS are accepted as clinically insignificant 3 . RIRS studies have shown that in almost 20% of cases, clinically insignificant RSFs are observed postoperatively 4 ; however, these RSF may grow and cause stone-related events (SRE) such as pain and infection 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Second-Look Flexible Ureterorenoscopy: A Technique Proposal to Achieve Real Stone Free Status

Cebeci

Özkan

Yalçın³

et al. 2021

Preprint

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Introduction Residual stone fragments remain a challenging topic for urologists following retrograde intrarenal surgery (RIRS). This study investigates the effectiveness of second-look flexible ureterorenoscopy (URS) to achieve a true stone-free status and decrease stone-related events. Material and Method A total of 176 consecutive patients treated with RIRS for kidney stones were included in the study. Patients were divided into two groups, group 1 receiving the standard of care (n=51) and group 2 receiving second-look flexible URS (n=125). In all cases, one or more calyceal stones of 1 to 4 mm were extracted with a basket at the time of stent removal. Unless earlier intervention was necessary, patients were followed up every six months to determine if they had experienced SREs. Results The mean follow-up time for the whole group was 21±11.1 months. The mean number of stones in group 1 and group 2 was 1.25±0.11 and 1.56±0.19, respectively. Postoperative stone-free rate after RIRS for group 1 and group 2 were 37.25% (n=19/51) and 40.8% (n=51/125), respectively. The SFR improved to 93.6% (n=117/125) in group 2. Multivariable analysis showed that type of intervention, stone size, and body mass index were independent prognostic factors for SREs. When group 2 was taken as a reference, the odds ratio for SREs was 8.48 (95% CI: 2.95–24.42) in group 1. Conclusion This study found that second-look flexible URS increased the SFRs and diminished the number of SREs. We propose performing second-look flexible URS following RIRS in the presence or suspicion of RSFs to provide better treatment results, less radiation exposure, and greater patient satisfaction. Key Words Retrograde Intrarenal Surgery, Flexible Ureteroscopy, Stone-free Rate, Residual stone Fragments, Stone-Related Event, Second-look Flexible Ureteroscopy.

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Which factors affect the hospital re-admission and re-hospitalization after flexible ureterorenoscopy for kidney stone?

Abstract: We found that inability to achieve stone-free status predicted HR and re-hospitalization, while postoperative complication and prolonged hospitalization also predicted re-hospitalization.

Cited by 10 publications

References 12 publications

Anaesthetic Management of Patients Undergoing Bariatric Surgery

Anaesthetic Management of Patients Undergoing Bariatric Surgery

Ureterorenoscopic stone procedures have low success rates and poor post‐operative follow‐up: results from an Australian tertiary health service

Second-Look Flexible Ureterorenoscopy: A Technique Proposal to Achieve Real Stone Free Status

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