Ong, William Lay Keat and Somani, Bhaskar Kumar and Fong, Khi Yung and Teoh, Jeremy Yuen-Chun and Sarica, Kemal and Chai, Chu Ann and Ragoori, Deepak and Tailly, Thomas and Hamri, Saeed Bin and Heng, Chin Tiong and Biligere, Sarvajit and Emiliani, Esteban and Gadzhiev, Nariman and Tanidir, Yiloren and Chew, Ben Hall and Castellani, Daniele and Traxer, Oliver and Gauhar, Vineet and Reg, FLEXible Ureteroscopy Outcomes (2024) Retrograde intrarenal surgery for asymptomatic incidental renal stones: a retrospective, real-world data analysis. BJU International, 134 (2). pp. 201-206. ISSN 1464-4096, DOI https://doi.org/10.1111/bju.16292.
Full text not available from this repository.Abstract
Objective<br /> To determine surgical outcomes and stone-free rates (SFRs) when offering upfront retrograde intrarenal surgery (RIRS) to patients with asymptomatic incidental renal stones (AIRS), as active surveillance, shockwave lithotripsy or upfront intervention in patients with AIRS is still a debate among urologists. Patients and Methods<br /> This retrospective FLEXible Ureteroscopy Outcomes Registry (FLEXOR), supported by the Team of Worldwide Endourological Researchers (TOWER), examines adult patients who underwent RIRS. We analysed a subset of asymptomatic patients with renal stones on imaging who were treated with RIRS. Data includes patient characteristics, stone specifications, anaesthesia type, perioperative details, complications, and SFR. A multivariable logistic regression analysis was performed to assess factors associated with the SFR. Results<br /> Among 679 patients with AIRS, 640 met the inclusion criteria. The median age was 55 years, with 33.4% being female. In all, 22.1% had positive urine cultures. The median stone diameter was 12 mm, commonly in lower and interpolar locations. RIRS was preferentially performed under general anaesthesia using a reusable scope in 443 cases. Prophylactic antibiotics were administered to 314 patients. The median operation time was 58 min and the median laser time was 24 min. The SFR was 68.8%. The use of holmium laser (odds ratio OR] 0.21, 95% confidence interval CI] 0.06-0.63; P < 0.01) and multiple stones (OR 0.38, 95% CI 0.19-0.76; P < 0.01) were factors associated with lower odds of being stone free. Overall complications were minimal, with sepsis in 1.6% of patients. Re-interventions were performed in 76 cases (11.8%), with RIRS being the most common in 67 cases (10.6%). Conclusion<br /> Our multicentre real-world study is the first of its kind that highlights the pros and cons of offering RIRS to patients with AIRS and demonstrates a favourable SFR with acceptable complications. Pre-emptively discussing potential re-intervention helps patients make informed decisions, particularly in cases involving large and multiple stones.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | asymptomatic incidental renal stones; flexible ureterorenoscopy; retrograde intrarenal surgery; stone-free rate; real-world data |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Surgery Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 06 Jan 2025 02:19 |
| Last Modified: | 06 Jan 2025 02:19 |
| URI: | http://eprints.um.edu.my/id/eprint/47051 |
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