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Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results

Asian Journal of Urology 2023年第1期10卷 58-63页

作者： Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz Department of Urology Rabin Medical Center-Beilinson HospitalPetach TikvaSackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael Department of Urology State University of New York Upstate Medical UniversitySyracuseNYUSA

Objective:To evaluate the long-term stone-free rate(SFR)of retrograde intrarenal surgery(RIRS)in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free ***:All consecutive patients undergoing RIRS lower pole renal calculi at a single highvolume tertiary center were analyzed *** pole stones were relocated to the upper pole,where laser lithotripsy was *** patients were followed up in the clinic following the surgery and yearly *** stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray,or an abdominal non-contrast computed tomography if the stones were known to be ***:A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi,between January 2012 and December 2018,were analyzed from a prospectively maintained database of 3000 *** a median follow-up time of 18.6 months,the mean SFR was 94.8%.The procedures were unsuccessful in 26(5.4%)patients due to unreachable *** median stone size of the unreachable stones was 12 mm(range 10e30 mm).Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones:a small cumulative stone burden(odds ratio[OR]:0.903,95%confidence interval[CI]:0.867e0.941,p<0.0001)and preoperative ureteral stent insertion(OR:0.515,95%CI:0.318e0.835,pZ0.007).Conclusion:The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high.

关键词： Ureteroscopy Lower pole stones Retrograde intrarenal surgery Stone-free rate basketing

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