Retrograde intrarenal surgery of renal stones: a critical multi-aspect evaluation of the outcomes by the Turkish Academy of Urology Prospective Study Group (ACUP Study).

Autor: Guven S; Department of Urology, Istanbul Medipol University, TEM Otoyolu No. 1, Bagcilar, 34214, Istanbul, Turkey. selcukguven@hotmail.com., Yigit P; Department of Medical Statistics and Medical Informatics, Istanbul Medipol University, Istanbul, Turkey., Tuncel A; Department of Urology, Ankara Numune Research and Training Hospital, University of Health Sciences, Ankara, Turkey., Karabulut İ; Department of Urology, Erzurum Research and Training Hospital, University of Health Sciences, Erzurum, Turkey., Sahin S; Department of Urology, Bakirköy Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey., Kilic O; Department of Urology, Selcuklu Medical School, Selcuk University, Konya, Turkey., Balasar M; Department of Urology, Meram Medical School, Necmettin Erbakan University, Konya, Turkey., Seckiner I; Department of Urology, Gaziantep University, Gaziantep, Turkey., Canda E; Department of Urology, Yıldırım Beyazit University, Ankara, Turkey., Sonmez MG; Department of Urology, Meram Medical School, Necmettin Erbakan University, Konya, Turkey., Tefik T; Department of Urology, Istanbul Medical School, Istanbul University, Istanbul, Turkey., Boz MY; Department of Urology, Istanbul Medipol University, TEM Otoyolu No. 1, Bagcilar, 34214, Istanbul, Turkey., Atis G; Department of Urology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey., Ergin G; Department of Urology, Koru Hospital, Ankara, Turkey., Soytas M; Department of Urology, Bakirköy Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey., Senel Ç; Department of Urology, Ankara Numune Research and Training Hospital, University of Health Sciences, Ankara, Turkey., Kirac M; Department of Urology, Koru Hospital, Ankara, Turkey., Kiremit MC; Department of Urology, Koc University, Istanbul, Turkey., Akand M; Department of Urology, Selcuklu Medical School, Selcuk University, Konya, Turkey., Tugcu V; Department of Urology, Bakirköy Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey., Erkurt B; Department of Urology, Istanbul Medipol University, TEM Otoyolu No. 1, Bagcilar, 34214, Istanbul, Turkey., Muslumanoglu A; Department of Urology, Bagcilar Research and Training Hospital, University of Health Sciences, Istanbul, Turkey., Sarica K; Department of Urology, Biruni University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2021 Feb; Vol. 39 (2), pp. 549-554. Date of Electronic Publication: 2020 Apr 28.
DOI: 10.1007/s00345-020-03210-2
Abstrakt: Aims: To outline and evaluate the incidence, management and follow-up of the residual fragments (RFs) following retrograde intrarenal surgery (RIRS) of renal stones by the Turkish Academy of Urology Prospective Study Group (ACUP Study).
Methods: Following the ethical committee approval, 15 centers providing data regarding the incidence, management, and follow-up of RFs after RIRS were included and all relevant information was recorded into the same electronic database program ( https://acup.uroturk.org.tr/ ) created by Turkish Urology Academy for Residual Stone Study.
Results: A total of 1112 cases underwent RIRS for renal calculi and RFs were observed in 276 cases (24.8%). Of all the parameters evaluated, our results demonstrated no statistically significant relation between preoperative DJ stenting and the presence of RFs (χ2 (1) = 158.418; p = 0.099). RFs were significantly higher in patients treated with UAS (82 patients, 29.3%) during the procedure compared to the cases who did not receive UAS (194 patients, 23.3%) (χ2 (1) = 3.999; p = 0.046). The mean period for a secondary intervention after RIRS was 28.39 (± 12.52) days. Regarding the procedures applied for RF removal, re-RIRS was the most commonly performed approach (56%).
Conclusions: Despite the reported safe and successful outcomes, the incidence of RFs is higher, after the RIRS procedure particularly in cases with relatively larger calculi. Such cases need to be followed in a close manner and although a second flexible ureteroscopy is the treatment of choice for fragment removal in the majority of these patients, shock wave lithotripsy and percutaneous nephrolithotomy may also be preferred in selected cases.
Databáze: MEDLINE
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