Stone free rate and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS): Our experience in 571 consecutive cases.

Abstract

INTRODUCTION:

The purpose of this study is to report the stone free rate (SFR) and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS).

MATERIALS AND METHODS:

A total of 571 procedures of upper urinary stones treated using flexible ureteroscopy and holmium laser lithotripsy from January 2014 to February 2020 have been analyzed. Overall SFR was evaluated after 3 months following the procedure by means of a non-contrast computed tomography. Success was considered as stone-free status or ≤ 0.4 cm fragments.

RESULTS:

The overall SFR was 92.3% in group 1 (stone size: < 1 cm), 88.3% in group 2 (stone size: > 1 ≤ 2 cm), 56.7% in group 3 (stone size: 2-3 cm) and 69.6% in group 4 (multiple stones). Post-operative complications, according to the Clavien- Dindo (CD) classification system, were recorded in 32 (5.6%) procedures. The major complications recorded were: one case of subcapsular hematoma (SRH) associated with pulmonary embolism two days after the procedure (CD Grade IIIa) treated conservatively and one case of hemorrhagic shock 2 hour with multiple renal bleedings requiring urgent nephrectomy (CD Grade IVA).

CONCLUSIONS:

The RIRS is an effective and safe procedure with a high SFR significantly correlated with the stone size; at the same time, RIRS could be characterized by severe clinical complications that require rapid diagnosis and prompt treatment.

• Authors: Orazio Maugeri, Ettore Dalmasso, Dario Peretti, Fabio Venzano, Germano Chiapello, Carlo Ambruosi, Claudio Dadone, Astrid Bonaccorsi, Pietro Pepe, Letterio D'Arrigo, Michele Pennisi
• Journal: Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica (Arch Ital Urol Androl) Vol. 93 Issue 3 Pg. 313-317 (Oct 01 2021) ISSN: 2282-4197 [Electronic] Italy
• PMID: 34839636 (Publication Type: Journal Article)

Topics

• Humans
• Kidney
• Kidney Calculi (surgery)
• Lithotripsy
• Lithotripsy, Laser (adverse effects)
• Postoperative Complications (epidemiology, etiology)
• Treatment Outcome
• Ureteroscopy (adverse effects)