Categorizing Intraoperative Complications of Retrograde Intrarenal Surgery

Abstract

Purpose: To review our intraoperative complications of retrograde intrarenal surgery (RIRS) for kidney calculi and stratify these complications according to the modified Satava classification system (SCS). Patients and Methods: 230 patients (119 males, 111 females) who underwent RIRS because of kidney calculi were analyzed. We documented and stratified the intraoperative complications according to the modified SCS. There are four grades for this classification: grade 1 complications include events without consequences for patients; grade 2a complications include events that could be treated with endoscopic surgery intraoperatively; grade 2b complications include events which were treated with endoscopic treatment in another session, and grade 3 describes the events requiring laparoscopic or open surgery. Results: Mean age was 39.1 years (range 1-78). The stone-free rate after one session was 81%. Intraoperative complications were recorded in 30.4% of the patients. According to the modified SCS, grade 1 complications were documented in 15.9%, grade 2a complications were documented in 5.6%, and grade 2b complications were documented in 8.9% of the patients. Grade 3 complications were not detected in any of the patients. Conclusion: In our opinion, the modified SCS can facilitate patients to understand the safety of this surgery and can make it easier to compare the results of different institutes and surgeons.

Factors associated with postoperative pain after retrograde intrarenal surgery for kidney stones

“…[1][2][3][4][5][6] The RIRS procedure can be considered as a safe method due to rarely occurence of major complications as classified according to Satava III or Clavien III-V criteria. [7,8] Only a limited number of studies so far have investigated the complications developed after RIRS, and they only presented some severe complications of the procedure. [3,5,6] But none of them investigated the postoperative pain as a complication, because it is a rather subjective symptom.…”

“…[3,5,6] But none of them investigated the postoperative pain as a complication, because it is a rather subjective symptom. A classification system has been used for categorizing intraoperative complications of RIRS by using modified Satava classification system for the first time, recently [7] , however because the study was designed in a retrospective nature, colic pain was not evaluated as a complication. To our knowledge, there is not any publication focusing on the postoperative pain and associated factors after flexible ureteroscopy, and the present one is the first study about this topic.…”

“…[1][2][3][4][5][6] Retrograde intrarenal surgery can be considered as a quite safe method because major complications rarely occur after the procedure. [7] However, only a limited number of studies have investigated the complications after RIRS. [3,5,6] Those publications mention some complications of their series, and a few of them focus on the procedural postoperative pain.…”

“…[3,5,6] Those publications mention some complications of their series, and a few of them focus on the procedural postoperative pain. We categorized intraoperative complications of RIRS by using modified Satava classification system for the first time [7] , but we did not evaluate the postoperative pain as a complication because it is rather subjective.…”

Retrograde intrarenal surgery for renal stones - Part 1

“…No difference was found in regards of postoperative complications and readmission rates between semi-rigid and flexible URS groups. [52] Oguz et al [53] reported rate of intraoperative complications as 30.4% according to modified Satava classification system. Grade 1, 2a and 2b complications were documented in 15.9%, 5.6% and 8.9% of the patients respectively, where no grade 3 complication was observed.…”