Gauhar, Vineet and Chai, Chu Ann and Chew, Ben H. and Singh, Abhishek and Castellani, Daniele and Tailly, Thomas and Emiliani, Esteban and Keat, William Ong Lay and Ragoori, Deepak and Lakmichi, Mohamed Amine and Teoh, Jeremy Yuen-Chun and Traxer, Olivier and Somani, Bhaskar Kumar (2023) RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study. Therapeutic Advances in Urology, 15. p. 17562872231158072. ISSN 1756-2872, DOI https://doi.org/10.1177/17562872231158072.
Full text not available from this repository.Abstract
Introduction:With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage. Methods:Retrospective analysis was performed on the FLEXOR registry, which was created as a TOWER group (Team of Worldwide Endourological Researchers, research wing of the Endourological Society) endeavor. Patients who underwent retrograde intrarenal surgery (RIRS) for renal stones from January 2018 to August 2021 were enrolled from 20 centers globally. A total of 6663 patients whose data were available for analysis were divided into Group 1 (Reusable scopes, 4808 patients) versus Group 2 (Disposable scopes, 1855 patients). Results:The age and gender distribution were similar in both groups. The mean stone size was 11.8 mm and 9.6 mm in Groups 2 and 1, respectively (p < 0.001). Group 2 had more patients with >2 cm stones, lower pole stones and of higher Hounsfield unit. Thulium fiber laser (TFL) was used more in Group 2 (p < 0.001). Patients in Group 2 had a slightly higher stone-free rate (SFR) (78.22%) and a lower number of residual fragments (RFs) compared with Group 1 (p < 0.001). The need for further treatments for RF and overall complications was comparable between groups. On multivariate analysis, overall complications were more likely to occur in elderly patients, larger stone size, lower pole stones, and were also more when using disposable scopes with longer operative time. RFs were significantly higher (p < 0.001) for lower pole, larger, harder, multiple stones and in elderly. Conclusion:Our real-world practice observations suggest that urologists choose disposable scopes for bigger, lower pole, and harder stones, and it does indeed help in improving the single-stage SFR if used correctly, with the appropriate lasers and lasing techniques in expert hands.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | disposable; kidney calculi; laser; RIRS; ureteroscopy |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Surgery Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 28 Nov 2024 02:21 |
| Last Modified: | 28 Nov 2024 02:21 |
| URI: | http://eprints.um.edu.my/id/eprint/47190 |
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