Feasibility of single-session endoscopic combined intrarenal surgery for ipsilateral large renal stones and retrograde intrarenal surgery for contralateral renal stones: Initial experience

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Abstract

Objectives: To analyze the feasibility of carrying out endoscopic combined intrarenal surgery with supine miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery for patients with bilateral stones in a single session. Methods: The records of consecutive patients presenting with bilateral kidney stones who underwent endoscopic combined intrarenal surgery with miniaturized percutaneous nephrolithotomy (15-Fr miniaturized nephroscope) and retrograde intrarenal surgery on one side, and retrograde intrarenal surgery on the contralateral side were prospectively collected and analyzed. After the miniaturized percutaneous nephrolithotomy procedure, flexible uretero-renoscopy was carried out for active removal of the stone fragments. Subsequently, retrograde intrarenal surgery was carried out on the contralateral side. Results: Overall, 26 patients were included in the analysis. The stone-free rate of the initial endoscopic combined intrarenal surgery side was 76.9% (20/26), and the stone-free rate of the contralateral retrograde intrarenal surgery side was 92.3% (24/26). Complications occurred in two patients (postoperative bleeding and urinary tract infection); however, these conditions were completely resolved with appropriate medications within 2 weeks postoperatively. Univariate logistic regression analyses showed that accumulation of surgical experience (OR 117.3, P = 0.046) was a significant predictor for stone-free status. Conclusion: Carrying out endoscopic combined intrarenal surgery and contralateral retrograde intrarenal surgery in a single session for patients with bilateral stones is feasible and safe.

Original languageEnglish
Pages (from-to)377-382
Number of pages6
JournalInternational Journal of Urology
Volume24
Issue number5
DOIs
StatePublished - 1 May 2017

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Kidney
Percutaneous Nephrostomy
Kidney Calculi
Urinary Tract Infections
Logistic Models
Regression Analysis
Hemorrhage

Keywords

  • kidney calculi
  • nephrolithiasis
  • ureterorenoscopes
  • urinary calculi

Cite this

@article{a1294d5d02f34bf5a8cc0ddb3bdb7f37,
title = "Feasibility of single-session endoscopic combined intrarenal surgery for ipsilateral large renal stones and retrograde intrarenal surgery for contralateral renal stones: Initial experience",
abstract = "Objectives: To analyze the feasibility of carrying out endoscopic combined intrarenal surgery with supine miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery for patients with bilateral stones in a single session. Methods: The records of consecutive patients presenting with bilateral kidney stones who underwent endoscopic combined intrarenal surgery with miniaturized percutaneous nephrolithotomy (15-Fr miniaturized nephroscope) and retrograde intrarenal surgery on one side, and retrograde intrarenal surgery on the contralateral side were prospectively collected and analyzed. After the miniaturized percutaneous nephrolithotomy procedure, flexible uretero-renoscopy was carried out for active removal of the stone fragments. Subsequently, retrograde intrarenal surgery was carried out on the contralateral side. Results: Overall, 26 patients were included in the analysis. The stone-free rate of the initial endoscopic combined intrarenal surgery side was 76.9{\%} (20/26), and the stone-free rate of the contralateral retrograde intrarenal surgery side was 92.3{\%} (24/26). Complications occurred in two patients (postoperative bleeding and urinary tract infection); however, these conditions were completely resolved with appropriate medications within 2 weeks postoperatively. Univariate logistic regression analyses showed that accumulation of surgical experience (OR 117.3, P = 0.046) was a significant predictor for stone-free status. Conclusion: Carrying out endoscopic combined intrarenal surgery and contralateral retrograde intrarenal surgery in a single session for patients with bilateral stones is feasible and safe.",
keywords = "kidney calculi, nephrolithiasis, ureterorenoscopes, urinary calculi",
author = "Ohseong Kwon and Park, {Ju Hyun} and Cho, {Min Chul} and Hwancheol Son and Hyeon Jeong and Cho, {Sung Yong}",
year = "2017",
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doi = "10.1111/iju.13313",
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TY - JOUR

T1 - Feasibility of single-session endoscopic combined intrarenal surgery for ipsilateral large renal stones and retrograde intrarenal surgery for contralateral renal stones

T2 - Initial experience

AU - Kwon, Ohseong

AU - Park, Ju Hyun

AU - Cho, Min Chul

AU - Son, Hwancheol

AU - Jeong, Hyeon

AU - Cho, Sung Yong

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objectives: To analyze the feasibility of carrying out endoscopic combined intrarenal surgery with supine miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery for patients with bilateral stones in a single session. Methods: The records of consecutive patients presenting with bilateral kidney stones who underwent endoscopic combined intrarenal surgery with miniaturized percutaneous nephrolithotomy (15-Fr miniaturized nephroscope) and retrograde intrarenal surgery on one side, and retrograde intrarenal surgery on the contralateral side were prospectively collected and analyzed. After the miniaturized percutaneous nephrolithotomy procedure, flexible uretero-renoscopy was carried out for active removal of the stone fragments. Subsequently, retrograde intrarenal surgery was carried out on the contralateral side. Results: Overall, 26 patients were included in the analysis. The stone-free rate of the initial endoscopic combined intrarenal surgery side was 76.9% (20/26), and the stone-free rate of the contralateral retrograde intrarenal surgery side was 92.3% (24/26). Complications occurred in two patients (postoperative bleeding and urinary tract infection); however, these conditions were completely resolved with appropriate medications within 2 weeks postoperatively. Univariate logistic regression analyses showed that accumulation of surgical experience (OR 117.3, P = 0.046) was a significant predictor for stone-free status. Conclusion: Carrying out endoscopic combined intrarenal surgery and contralateral retrograde intrarenal surgery in a single session for patients with bilateral stones is feasible and safe.

AB - Objectives: To analyze the feasibility of carrying out endoscopic combined intrarenal surgery with supine miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery for patients with bilateral stones in a single session. Methods: The records of consecutive patients presenting with bilateral kidney stones who underwent endoscopic combined intrarenal surgery with miniaturized percutaneous nephrolithotomy (15-Fr miniaturized nephroscope) and retrograde intrarenal surgery on one side, and retrograde intrarenal surgery on the contralateral side were prospectively collected and analyzed. After the miniaturized percutaneous nephrolithotomy procedure, flexible uretero-renoscopy was carried out for active removal of the stone fragments. Subsequently, retrograde intrarenal surgery was carried out on the contralateral side. Results: Overall, 26 patients were included in the analysis. The stone-free rate of the initial endoscopic combined intrarenal surgery side was 76.9% (20/26), and the stone-free rate of the contralateral retrograde intrarenal surgery side was 92.3% (24/26). Complications occurred in two patients (postoperative bleeding and urinary tract infection); however, these conditions were completely resolved with appropriate medications within 2 weeks postoperatively. Univariate logistic regression analyses showed that accumulation of surgical experience (OR 117.3, P = 0.046) was a significant predictor for stone-free status. Conclusion: Carrying out endoscopic combined intrarenal surgery and contralateral retrograde intrarenal surgery in a single session for patients with bilateral stones is feasible and safe.

KW - kidney calculi

KW - nephrolithiasis

KW - ureterorenoscopes

KW - urinary calculi

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