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Treatment outcomes of retrograde intrarenal surgery for renal stones and predictive factors of stone-free.

Lim SH, Jeong BC, Seo SI, Jeon SS, Han DH - Korean J Urol (2010)

Bottom Line: Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated.In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate.The overall complication rate was 6%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free.

Materials and methods: We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated.

Results: Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9±392.5 mm(2). The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%.

Conclusions: RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones.

No MeSH data available.


Related in: MedlinePlus

Locations of stones and stone-free rates (Group 1: upper pole or mid pole or renal pelvis, Group 2: lower pole only, Group 3: lower pole with others).
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Figure 1: Locations of stones and stone-free rates (Group 1: upper pole or mid pole or renal pelvis, Group 2: lower pole only, Group 3: lower pole with others).

Mentions: Immediate postoperative SFRs according to the variables analyzed are listed in Table 3. The SFR was significantly higher in primary RIRS than in secondary RIRS (83.3% vs. 58.3%, p<0.05). SFRs according to stone location were 94.4% for renal stones that were located in the upper pole or midpole or renal pelvis and 60.4% for those located in the lower pole with or without others, respectively (p<0.05). When stone locations were subdivided into 3 groups, including the upper pole or midpole or renal pelvis, the lower pole only, and the lower pole with others, the SFRs of each group were 94.4% (17/18), 73.3% (22/30), and 38.9% (7/18), respectively (Fig. 1). Renal stones with a cumulative stone burden ≤150 mm2 and a stone number of 1 to 2 stones presented a significantly higher SFR (p<0.05). No significant correlation between the SFR and radio-opacity or the presence of combined ureteral stones was found. Multivariate analysis of these factors showed that stone location and cumulative stone burden remained significant predictive factors of the immediate postoperative SFR (OR: 19.05 and 33.05, p<0.05) (Table 4).


Treatment outcomes of retrograde intrarenal surgery for renal stones and predictive factors of stone-free.

Lim SH, Jeong BC, Seo SI, Jeon SS, Han DH - Korean J Urol (2010)

Locations of stones and stone-free rates (Group 1: upper pole or mid pole or renal pelvis, Group 2: lower pole only, Group 3: lower pole with others).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2991576&req=5

Figure 1: Locations of stones and stone-free rates (Group 1: upper pole or mid pole or renal pelvis, Group 2: lower pole only, Group 3: lower pole with others).
Mentions: Immediate postoperative SFRs according to the variables analyzed are listed in Table 3. The SFR was significantly higher in primary RIRS than in secondary RIRS (83.3% vs. 58.3%, p<0.05). SFRs according to stone location were 94.4% for renal stones that were located in the upper pole or midpole or renal pelvis and 60.4% for those located in the lower pole with or without others, respectively (p<0.05). When stone locations were subdivided into 3 groups, including the upper pole or midpole or renal pelvis, the lower pole only, and the lower pole with others, the SFRs of each group were 94.4% (17/18), 73.3% (22/30), and 38.9% (7/18), respectively (Fig. 1). Renal stones with a cumulative stone burden ≤150 mm2 and a stone number of 1 to 2 stones presented a significantly higher SFR (p<0.05). No significant correlation between the SFR and radio-opacity or the presence of combined ureteral stones was found. Multivariate analysis of these factors showed that stone location and cumulative stone burden remained significant predictive factors of the immediate postoperative SFR (OR: 19.05 and 33.05, p<0.05) (Table 4).

Bottom Line: Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated.In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate.The overall complication rate was 6%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free.

Materials and methods: We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated.

Results: Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9±392.5 mm(2). The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%.

Conclusions: RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones.

No MeSH data available.


Related in: MedlinePlus