학술논문
Improving Outcomes of Same-sitting Bilateral Flexible Ureteroscopy for Renal Stones in Real-world Practice—Lessons Learnt from Global Multicenter Experience of 1250 Patients
Document Type
article
Author
Daniele Castellani; Olivier Traxer; Deepak Ragoori; Andrea Benedetto Galosi; Virgilio De Stefano; Nariman Gadzhiev; Yiloren Tanidir; Takaaki Inoue; Esteban Emiliani; Saeed Bin Hamri; Mohamed Amine Lakmichi; Chandra Mohan Vaddi; Chin Tiong Heng; Boyke Soebhali; Sumit More; Vikram Sridharan; Mehmet Ilker Gökce; Azimdjon N. Tursunkulov; Arvind Ganpule; Giacomo Maria Pirola; Angelo Naselli; Cemil Aydin; Fernando Ramón de Fata Chillón; Catalina Solano Mendoza; Luigi Candela; Ben Hall Chew; Bhaskar Kumar Somani; Vineet Gauhar
Source
European Urology Open Science, Vol 52, Iss , Pp 51-59 (2023)
Subject
Language
English
ISSN
2666-1683
Abstract
Background: Bilateral kidney stones are commonly treated in staged procedures. Objective: To evaluate outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones. Design, setting, and participants: Data from adults who underwent bilateral RIRS in 21 centers were retrospectively reviewed (from January 2015 to June 2022). The inclusion criteria were unilateral/bilateral symptomatic bilateral stone(s) of any size/location in both kidneys and bilateral stones on follow-up with symptom/stone progression. Stone-free rate (SFR) was defined as absence of any fragment >3 mm at 3 mo. Outcome measurements and statistical analysis: Continuous variables are presented as medians and 25–75th percentiles. A multivariable logistic regression analysis was performed to evaluate independent predictors of sepsis and bilateral SFR. Results and limitations: A total of 1250 patients were included. The median age was 48.0 (36–61) yr. Of the patients, 58.2% were prestented. The median stone diameter was 10 mm on both sides. Multiple stones were present in 45.3% and 47.9% of the left and right kidneys, respectively. Surgery was stopped in 6.8% of cases. The median surgical time was 75.0 (55–90) min. Complications were transient fever (10.7%), fever/infection needing prolonged stay (5.5%), sepsis (2%), and blood transfusion (1.3%). Bilateral and unilateral SFRs were 73.0% and 17.4%, respectively. Female (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.18–7.49, p = 0.02), no antibiotic prophylaxis (OR 5.99, 95% CI 2.28–15.73, p