Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results
Objective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status. Methods: All consecutive patients undergoing RIRS lower pole renal c...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Asian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388221000862 |
| _version_ | 1797950721874722816 |
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| author | Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz |
| author_facet | Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz |
| author_sort | Dor Golomb |
| collection | DOAJ |
| description | Objective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status. Methods: All consecutive patients undergoing RIRS lower pole renal calculi at a single high-volume tertiary center were analyzed retrospectively. Lower pole stones were relocated to the upper pole, where laser lithotripsy was performed. All patients were followed up in the clinic following the surgery and yearly thereafter. The stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray, or an abdominal non-contrast computed tomography if the stones were known to be radiolucent. Results: A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi, between January 2012 and December 2018, were analyzed from a prospectively maintained database of 3000 ureteroscopies. With a median follow-up time of 18.6 months, the mean SFR was 94.8%. The procedures were unsuccessful in 26 (5.4%) patients due to unreachable stones. The median stone size of the unreachable stones was 12 mm (range 10–30 mm). Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones: a small cumulative stone burden (odds ratio [OR]: 0.903, 95% confidence interval [CI]: 0.867–0.941, p<0.0001) and preoperative ureteral stent insertion (OR: 0.515, 95% CI: 0.318–0.835, p=0.007). Conclusion: The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high. |
| first_indexed | 2024-04-10T22:19:38Z |
| format | Article |
| id | doaj.art-41f011ca4070464cb98c6760dce4fa92 |
| institution | Directory Open Access Journal |
| issn | 2214-3882 |
| language | English |
| last_indexed | 2024-04-10T22:19:38Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj.art-41f011ca4070464cb98c6760dce4fa922023-01-18T04:31:11ZengElsevierAsian Journal of Urology2214-38822023-01-011015863Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent resultsDor Golomb0Hanan Goldberg1Shlomi Tapiero2Yariv Stabholz3Paz Lotan4Abd Elhalim Darawsha5Ronen Holland6Yaron Ehrlich7David Lifshitz8Department of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Corresponding author.Department of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Urology, State University of New York Upstate Medical University, Syracuse, NY, USADepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelObjective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status. Methods: All consecutive patients undergoing RIRS lower pole renal calculi at a single high-volume tertiary center were analyzed retrospectively. Lower pole stones were relocated to the upper pole, where laser lithotripsy was performed. All patients were followed up in the clinic following the surgery and yearly thereafter. The stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray, or an abdominal non-contrast computed tomography if the stones were known to be radiolucent. Results: A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi, between January 2012 and December 2018, were analyzed from a prospectively maintained database of 3000 ureteroscopies. With a median follow-up time of 18.6 months, the mean SFR was 94.8%. The procedures were unsuccessful in 26 (5.4%) patients due to unreachable stones. The median stone size of the unreachable stones was 12 mm (range 10–30 mm). Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones: a small cumulative stone burden (odds ratio [OR]: 0.903, 95% confidence interval [CI]: 0.867–0.941, p<0.0001) and preoperative ureteral stent insertion (OR: 0.515, 95% CI: 0.318–0.835, p=0.007). Conclusion: The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high.http://www.sciencedirect.com/science/article/pii/S2214388221000862UreteroscopyLower pole stonesRetrograde intra-renal surgeryStone-free rateBasketing |
| spellingShingle | Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results Asian Journal of Urology Ureteroscopy Lower pole stones Retrograde intra-renal surgery Stone-free rate Basketing |
| title | Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| title_full | Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| title_fullStr | Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| title_full_unstemmed | Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| title_short | Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| title_sort | retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results |
| topic | Ureteroscopy Lower pole stones Retrograde intra-renal surgery Stone-free rate Basketing |
| url | http://www.sciencedirect.com/science/article/pii/S2214388221000862 |
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