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2015 ; 41
(3
): 113-8
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Flexible ureterorenoscopy results: Analysis of 279 cases
#MMPMID26516593
Elbir F
; Ba??büyük ?
; Topakta? R
; Karda? S
; Tosun M
; Tepeler A
; Arma?an A
Turk J Urol
2015[Sep]; 41
(3
): 113-8
PMID26516593
show ga
OBJECTIVE: In this study, the outcomes of 279 cases in whom we performed
retrograde intrarenal surgery (RIRS) were evaluated retrospectively. MATERIAL AND
METHODS: RIRS was performed on 279 cases with the aid of access sheath of
guidewire between March 2011 and February 2015. All patients were operated in the
standard lithotomy position. A hydrophilic guidewire was inserted with the aid of
rigid ureterorenoscopy and we checked whether there were any residual ureteral
stones and other pathologies. Fluoroscopy was used routinely in all cases. Stone
fragments smaller than 3 mm were left off but those bigger than 3 mm were removed
by grasper after stone fragmentation. Controls of the patients were assessed by
plain films (KUB), urinary tract ultrasonography (US) and/or computed tomography
(CT) 1 month after the operation. Success rate of the procedure was defined as
the stone-free status or presence of residual fragments less than 3 mm. RESULTS:
152 of the patients were male and 127 were female. The median ages of the male
and female patients were 47.7 (1-86) ve 45.9 (3-79) years respectively. The
median stone size was 13.5 mm (8-25). Preoperatively 34 (12.1%) patients had
double-J ureteral stent. 19 (6.8%) patients were operated while they were still
receiving antithrombotic and antiplatelet therapy Solitary kidney was present in
24 patients while the remaining patients had kyphoscoliosis (n=3), rotation
anomaly (n=6), pelvic kidney (n=2), double collecting system (n=3), and horseshoe
kidney (n=6). In 264 patients access sheath was used, in 15 patients operation
was performed with the help of the guidewire. Double-J stents were inserted to 14
patients because of ureteral stricture and they underwent operation after 2 weeks
later. Renal stones of 219 patients among all cases were fragmented completely
and the patients were discharged as stone free (SF). Our success rate (SF or
presence of clinically insignificant residual [CIRF]) was 78.4%. Stone size
(p=0.029), stone number (p=0.01), stone location (p=0.023) had significant
influence on the stone-free rate after RIRS The mean operation and floroscopy
time was 62.5 min. (40-180) and 29.8 sec (4-96), respectively. The mean
hospitalization time was 26.4 hours (12-72). Double J stents were placed to 253
patients for more stone burden and ureteral edema. Any complication was not
observed for all cases except perioperative developed infection for two patients.
CONCLUSION: With advances in laser technology and flexible ureterorenoscopy,
kidney stones can be treated with lower morbidity and high success rates.
free
free
free
