The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries
<i>Background and Objectives</i>: Percutaneous nephrolithotomy (PCNL) is still the gold-standard treatment for large and/or complex renal stones. Endoscopic combined intrarenal surgery (ECIRS) was developed with the goal of minimizing the number of access tracts of PCNL while simultaneou...
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MDPI AG
2023-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/11/1971 |
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| author | Young Joon Moon Kang Su Cho Dae Chul Jung Doo Yong Chung Joo Yong Lee |
| author_facet | Young Joon Moon Kang Su Cho Dae Chul Jung Doo Yong Chung Joo Yong Lee |
| author_sort | Young Joon Moon |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Percutaneous nephrolithotomy (PCNL) is still the gold-standard treatment for large and/or complex renal stones. Endoscopic combined intrarenal surgery (ECIRS) was developed with the goal of minimizing the number of access tracts of PCNL while simultaneously improving the one-step stone-free rate (SFR). The aim of this study was to share the experience of the consecutive 200 cases of ECIRS in one institute and analyze surgical outcomes of mini-ECIRS and standard ECIRS. <i>Materials and Methods</i>: We performed ECIRS for 200 adult patients between July 2017 and January 2020. An ECIRS was performed with the patient under general anesthesia in the intermediate-supine position. Surgeries were finished using a tubeless technique with a simple ureteral stent insertion. <i>Results</i>: There were significant differences in the mean maximal stone length (MSL), the variation coefficient of stone density (VCSD), the linear calculus density (LCD), the Seoul National University Renal Stone Complexity (S-ReSC), and the modified S-ReSC scores in stone characteristics, and estimated blood loss (EBL) and operation time in peri-operative outcomes between conventional and mini-ECIRS. After propensity-score matching, there was only a difference in EBL between the two groups. In logistic regression models, MSL [odds ratio (OR) 0.953; 95% confidence interval (CI) 0.926–0.979; <i>p</i> < 0.001], LCD (OR 4.702; 95% CI 1.613–18.655; <i>p</i> = 0.013) were significant factors for the success rate after ECIRS. <i>Conclusions</i>: In patients who underwent a mini-ECIRS, the stones were relatively smaller and less complex, and the operation time was shorter. However, if the size of stones was similar, there was no difference in the success rate, but EBL was lower in mini-ECIRS than in standard surgery. |
| first_indexed | 2024-03-09T16:37:49Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:37:49Z |
| publishDate | 2023-11-01 |
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| series | Medicina |
| spelling | doaj.art-0d464f1cd54342ef940e50646e33e7052023-11-24T14:54:52ZengMDPI AGMedicina1010-660X1648-91442023-11-015911197110.3390/medicina59111971The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature SurgeriesYoung Joon Moon0Kang Su Cho1Dae Chul Jung2Doo Yong Chung3Joo Yong Lee4Department of Urology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu 41944, Republic of KoreaDepartment of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Republic of KoreaDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Urology, Inha University College of Medicine, Incheon 22212, Republic of KoreaDepartment of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea<i>Background and Objectives</i>: Percutaneous nephrolithotomy (PCNL) is still the gold-standard treatment for large and/or complex renal stones. Endoscopic combined intrarenal surgery (ECIRS) was developed with the goal of minimizing the number of access tracts of PCNL while simultaneously improving the one-step stone-free rate (SFR). The aim of this study was to share the experience of the consecutive 200 cases of ECIRS in one institute and analyze surgical outcomes of mini-ECIRS and standard ECIRS. <i>Materials and Methods</i>: We performed ECIRS for 200 adult patients between July 2017 and January 2020. An ECIRS was performed with the patient under general anesthesia in the intermediate-supine position. Surgeries were finished using a tubeless technique with a simple ureteral stent insertion. <i>Results</i>: There were significant differences in the mean maximal stone length (MSL), the variation coefficient of stone density (VCSD), the linear calculus density (LCD), the Seoul National University Renal Stone Complexity (S-ReSC), and the modified S-ReSC scores in stone characteristics, and estimated blood loss (EBL) and operation time in peri-operative outcomes between conventional and mini-ECIRS. After propensity-score matching, there was only a difference in EBL between the two groups. In logistic regression models, MSL [odds ratio (OR) 0.953; 95% confidence interval (CI) 0.926–0.979; <i>p</i> < 0.001], LCD (OR 4.702; 95% CI 1.613–18.655; <i>p</i> = 0.013) were significant factors for the success rate after ECIRS. <i>Conclusions</i>: In patients who underwent a mini-ECIRS, the stones were relatively smaller and less complex, and the operation time was shorter. However, if the size of stones was similar, there was no difference in the success rate, but EBL was lower in mini-ECIRS than in standard surgery.https://www.mdpi.com/1648-9144/59/11/1971kidneynephrolithiasislithotripsyurinary calculi |
| spellingShingle | Young Joon Moon Kang Su Cho Dae Chul Jung Doo Yong Chung Joo Yong Lee The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries Medicina kidney nephrolithiasis lithotripsy urinary calculi |
| title | The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries |
| title_full | The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries |
| title_fullStr | The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries |
| title_full_unstemmed | The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries |
| title_short | The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries |
| title_sort | consecutive 200 cases of endoscopic combined intrarenal surgery comparison between standard and miniature surgeries |
| topic | kidney nephrolithiasis lithotripsy urinary calculi |
| url | https://www.mdpi.com/1648-9144/59/11/1971 |
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