Comparative evaluation of retrograde intrarenal surgery using ureteral access sheath and fluoroscopy: a retrospective analysis on kidney stone treatment

Year 2023, Volume: 4 Issue: 5, 472 - 477, 27.10.2023

Kazım Doğan

https://doi.org/10.47582/jompac.1342127

Abstract

Aims: This study aimed to investigate the outcomes of retrograde intrarenal surgery (RIRS) with and without the utilization of ureteral access sheath (UAS) and fluoroscopy for treating kidney stones and its implications on postoperative complications.
Methods: Employing a retrospective design, we analyzed the records of 314 patients subjected to RIRS due to kidney stones. Patients were categorized into two groups based on the application of fluoroscopy and UAS (Group 1) versus non-application (Group 2). Various metrics, including stone-free rates, residual stone rates, and postoperative complications, were compared between the groups.
Results: The results showed no significant differences between the two groups regarding patient age, stone size, and several demographic parameters. However, there was a considerable reduction in operation duration in Group 2 (20.96±5.97 minutes) compared to Group 1 (26.15±5.41 minutes), where UAS and fluoroscopy were applied, with p=0.001. Furthermore, post-treatment results highlighted a decline in residual stone rates and an enhancement in stone-free rates, though differences between groups were not significant. The incidence of postoperative complications, like fever, urinary tract infections, and ureteral stenosis, was assessed, revealing no differences between the two groups.
Conclusion: The application of RIRS without UAS and fluoroscopy appears to be a promising approach to treating kidney stones, offering similar outcomes regarding stone removal efficacy and postoperative complications compared to the traditional method with UAS and fluoroscopy. This research emphasizes the potential of a less invasive method, warranting further studies to understand its broad implications.

Keywords

Retrograde intrarenal surgery, kidney stone, ureteral access sheath, fluoroscopy

Üreteral giriş kılıfı ve floroskopi kullanılarak yapılan retrograd intrarenal cerrahinin karşılaştırmalı değerlendirilmesi: böbrek taşı tedavisinde retrospektif bir analiz

Abstract

Amaç: Bu çalışmada böbrek taşlarının tedavisinde üreteral giriş kılıfı (UAS) ve floroskopi kullanılan ve kullanılmayan retrograd intrarenal cerrahinin (RIRS) sonuçları ve bunun ameliyat sonrası komplikasyonlar üzerindeki etkileri araştırıldı.
Yöntemler: Retrospektif bir tasarım kullanarak, böbrek taşı nedeniyle RİRS uygulanan 314 hastanın kayıtlarını analiz ettik. Hastalar floroskopi ve UAS uygulanmasına (Grup 1) ve uygulanmamasına (Grup 2) göre iki gruba ayrıldı. Taşsızlık oranları, rezidüel taş oranları ve ameliyat sonrası komplikasyonlar dahil olmak üzere çeşitli ölçütler gruplar arasında karşılaştırıldı.
Sonuçlar: Sonuçlar, hasta yaşı, taş boyutu ve çeşitli demografik parametreler açısından iki grup arasında anlamlı bir fark olmadığını gösterdi. Ancak, UAS ve floroskopi uygulanan Grup 1'e (26.15±5.41 dakika) kıyasla Grup 2'de (20.96±5.97 dakika) operasyon süresinde ile belirgin bir azalma görüldü. Ayrıca, tedavi sonrası sonuçlar, gruplar arasındaki farklar anlamlı olmasa da, rezidüel taş oranlarında bir düşüş ve taşsızlık oranlarında bir artış olduğunu vurgulamıştır. Ateş, idrar yolu enfeksiyonu ve üreter darlığı gibi ameliyat sonrası komplikasyonların insidansı değerlendirildi ve fark olmadığı görüldü.
Sonuç: UAS ve floroskopi olmadan RIRS uygulaması, böbrek taşlarının tedavisinde umut verici bir yaklaşım olarak görünmektedir ve UAS ve floroskopi ile geleneksel yönteme kıyasla taş çıkarma etkinliği ve postoperatif komplikasyonlar açısından benzer sonuçlar sunmaktadır. Bu araştırma, daha az invaziv bir yöntemin potansiyelini vurgulamakta ve geniş etkilerini anlamak için daha fazla çalışma yapılmasını gerektirmektedir.

Keywords

Retrograd intrarenal cerrahi, böbrek taşı, üreter giriş kılıfı, floroskopi

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