Indications, preferences, global practice patterns and outcomes in retrograde intrarenal surgery (RIRS) for renal stones in adults: results from a multicenter database of 6669 patients of the global FLEXible ureteroscopy Outcomes Registry (FLEXOR).

Autor: Gauhar V; Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Chew BH; Department of Urology, University of British Columbia, Vancouver, Canada., Traxer O; Department of Urology AP-HP, Sorbonne University, Tenon Hospital, Paris, France., Tailly T; Department of Urology, University Hospital of Ghent, Ghent, Belgium., Emiliani E; Urology Department, Universidad Autónoma de Barcelona, Fundación PuigvertBarcelona, Spain., Inoue T; Department of Urology and Stone Center, Hara Genitourinary Hospital, Kobe City, Hyogo, Japan., Tiong HC; Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Chai CA; Urology Unit, Department of Surgery, University Malaya, Kuala Lumpur, Malaysia., Lakmichi MA; Department of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, Morocco., Tanidir Y; Department of Urology, Marmara University School of Medicine, Istanbul, Turkey., Bin Hamri S; Division of Urology, Department of Surgery, Ministry of the National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia., Desai D; Department of Urology, Toowoomba Hospital, University of Queensland, Brisbane, Australia., Biligere S; Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Shrestha A; Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal., Soebhali B; Medical Faculty, Mulawarman University, Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia., Keat WOL; Department of Urology, Penang General Hospital, Penang, Malaysia., Mohan VC; Department of Urology, Preeti Urology and Kidney Hospital, Hyderabad, Telangana, India., Bhatia TP; Department of Urology, Sarvodaya Healthcare, Faridabad, Haryana, India., Singh A; Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India., Saleem M; Department of Urology, Apis Kidney Stone Institute, Urology Research and Day Care Center, Mangalore, Karnataka, India., Gorelov D; Endourology Department, Saint-Petersburg State Medical University, Saint-Petersburg, Russia., Gadzhiev N; Endourology Department, Saint-Petersburg State Medical University, Saint-Petersburg, Russia., Pietropaolo A; Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Galosi AB; Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, Via Conca 71, 60126, Ancona, Italy., Ragoori D; Department of Urology, Asian Institute of Nephrology & Urology, Irram Manzil Colony, Hyderabad, Telangana, India., Teoh JY; S. H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Somani BK; Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Castellani D; Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, Via Conca 71, 60126, Ancona, Italy. castellanidaniele@gmail.com.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2023 Feb; Vol. 41 (2), pp. 567-574. Date of Electronic Publication: 2022 Dec 19.
DOI: 10.1007/s00345-022-04257-z
Abstrakt: Purpose: To collect a multicentric database on behalf of TOWER research group to assess practice patterns and outcomes of retrograde intrarenal surgery (RIRS) for kidney stones.
Methods: Inclusion criteria: age ≥ 18 years, normal renal/calyceal system anatomy, calculi of any size, number, and position.
Study Period: January 2018 and August 2021. Stone-free status: absence of fragments > 2 mm, assessed post procedure according to the local protocol (KUB X-Ray and/or ultrasound or non-contrast CT scan).
Results: Twenty centers from fifteen countries enrolled 6669 patients. There were 4407 (66.2%) men. Mean age was 49.3 ± 15.59 years. Pain was the most frequent symptom indication for intervention (62.6%). 679 (10.2%) patients underwent RIRS for an incidental finding of stones. 2732 (41.0%) patients had multiple stones. Mean stone size was 10.04 ± 6.84 mm. A reusable flexible ureteroscope was used in 4803 (72.0%) procedures. A sheath-less RIRS was performed in 454 (6.8%) cases. Holmium:YAG laser was used in 4878 (73.1%) cases. A combination of dusting and fragmentation was the most common lithotripsy mode performed (64.3%). Mean operation time was 62.40 ± 17.76 min. 119 (1.8%) patients had an intraoperative injury of the ureter due to UAS insertion. Mean postoperative stay was 3.62 ± 3.47 days. At least one postoperative complication occurred in 535 (8.0%) patients. Sepsis requiring intensive care admission occurred in 84 (1.3%) patients. Residual fragments were detected in 1445 (21.7%) patients. Among the latter, 744 (51.5%) patients required a further intervention.
Conclusion: Our database contributes real-world data to support to a better understanding of modern RIRS practice and outcomes.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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