Comparison of mini endoscopic combined intrarenal surgery and multitract minimally invasive percutaneous nephrolithotomy specifically for kidney staghorn stones: a single-centre experience

Chen, Zhihao; Lee, Kau-Han; Tseng, Wen-Hsin; Su, Chin-Chuan; Hsieh, Kun-Pin; Lim, Chye-Yang; Huang, Steven Kuan-Hua

doi:10.1186/s12894-022-01030-7

Cited by 6 publications

(11 citation statements)

References 38 publications

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“…Liu et al [15] were the only group to make a head-to-head comparison of single-tract PCNL with single-tract ECIRS for stag horn stones, both done in prone position with the latter clearly the winner with a higher one stage SFR (84.4 vs. 57.9%, P = 0.007) and no statistically significant difference in complications. Chen et al [34] compared multitract PCNL vs. single-tract ECIRS in staghorn stones. As ECIRS had equal outcomes with no significant differences for operative time (140 vs. 183 min, P = 0.63) and no differences for haemoglobin loss, blood transfusion, complications or hospital stay they concluded that ECIRS is a safe equivalent.…”

Section: Discussionmentioning

confidence: 99%

“…The remaining 162 full-text articles were further evaluated for appropriateness and 127 articles were excluded. Finally, 35 articles were considered eligible and included [1,2 ▪ ,6–13,14 ▪ ,15–17,18 ▪▪ ,19 ▪ ,20–22,23 ▪▪ ,24,25 ▪▪ ,26–36,37 ▪ ,38]. Figure 1 shows the flow diagram of the literature search.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…There were 22 retrospective [6–13,14 ▪ ,17,19 ▪ ,20,24,25 ▪▪ ,26,28,31–34,36,38] and 7 prospective studies [1,2 ▪ ,18 ▪▪ ,21,23 ▪▪ ,27,29], and only one among the latter was randomized [29]. There were 16 single-arm studies [1,2 ▪ ,6,7,9–11,13,17,20,21,25 ▪▪ ,28,31,33,36], whilst 7 studies compared ECIRS with other procedures [8,12,14 ▪ ,18 ▪▪ ,24,26,34]. Yet, four studies compared ECIRS in different patient positions [19 ▪ ,27,32,38].…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Yet, four studies compared ECIRS in different patient positions [19 ▪ ,27,32,38]. Regarding percutaneous size tract, there were 19 studies using a standard PCNL [1,2 ▪ ,6,7,9,11–13,17,19 ▪ ,20,21,27–29,31–33,38] tract and 9 a mini-PCNL tract [8,10,14 ▪ ,18 ▪▪ ,23 ▪▪ ,24,25 ▪▪ ,34,36]. Only one study compared standard vs. mini-ECIRS [26].…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Only one study compared standard vs. mini-ECIRS [26]. Regarding patient position, there were 11 studies using the GMSV position [1,10,12,13,17,20,26,29,32–34], 2 studies supine position [11,18 ▪▪ ], 12 studies used the prone split-leg position [6–9,14 ▪ ,21,23 ▪▪ ,24,27,28,31,36], and 4 studies included different positions [19 ▪ ,24,27,38].…”

Section: Evidence Synthesismentioning

confidence: 99%

See 4 more Smart Citations

Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Gauhar

Traxer

Fuligni

et al. 2023

Current Opinion in Urology

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Purpose of reviewTo systematically review the evolution of techniques, technology, clinical utility, limitations and possible future applications of endoscopic combined intrarenal surgery (ECIRS) for ureteral and kidney stones. Recent findingsThe literature search was performed on 18th January 2023 using PubMed, EMBASE and Scopus. 35 studies were included. Among them, six were reviews. Since its introduction in 2008, ECIRS has evolved and improved. ECIRS can be performed in different patient position, such as modified supine Valdivia position by Galdakao, prone position with split-leg and supine position with good outcomes. Instrument miniaturization has also been introduced in ECIRS making it doable in an ambulatory setting. ECIRS showed shorter operative time, lower complication rate, and retreatment compared with conventional PCNL. Operative outcomes of mini-ECIRS are better than mini-PCNL alone. ECIRS also showed good outcomes in impacted upper ureteric stones. Recently, some studies have explored the robotic-assisted kidney puncture in ECIRS that avoided multitrack surgery, especially in anomalous kidney and staghorn stones. SummaryECIRS is ready for primetime in endourology and can be considered the next gold-standard for a personalized stone approach in complex kidney stones.

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Section: Discussionmentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

See 3 more Smart Citations

Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Gauhar

Traxer

Fuligni

et al. 2023

Current Opinion in Urology

View full text Add to dashboard Cite

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Antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi: a prospective randomized controlled study

Qi,

Xing,

Yang

et al. 2024

Urolithiasis

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The aim is to compare the efficacy and safety between single percutaneous nephrolithotomy (sPNL) and antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) for the treatment of staghorn calculi. A prospective randomized controlled study was conducted at the Second Hospital of Tianjin Medical University. A total of 160 eligible patients were included, with 81 in the sPNL group and 79 in the aPNL group. The study first compared the overall differences between sPNL and aPNL. Then, the patients were divided into two subgroups: Group 1 (with less than 5 stone branches) and Group 2 (with 5 or more stone branches), and the differences between the two subgroups were further analyzed. The results showed that aPNL had a higher stone-free rate (SFR) and required fewer percutaneous tracts, with a shorter operation time compared to sPNL (P < 0.05). Moreover, aPNL significantly reduced the need for staged surgery, particularly in patients with 5 or more stone branches. Moreover, there were no significant differences in the changes of hemoglobin levels and the need for blood transfusions between the sPNL and aPNL groups, and the incidence of multiple tracts was lower in the aPNL group. The two groups showed comparable rates of perioperative complications. We concluded that aPNL resulted in a higher SFR for staghorn calculi, and required fewer multiple percutaneous tracts, reduced the need for staged surgery, and had a shorter operative time than PNL alone, especially for patients with 5 or more stone branches. Furthermore, aPNL did not increase the incidence of surgical complications.

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The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries

Moon,

Cho,

Jung

et al. 2023

Medicina

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Background and Objectives: Percutaneous nephrolithotomy (PCNL) is still the gold-standard treatment for large and/or complex renal stones. Endoscopic combined intrarenal surgery (ECIRS) was developed with the goal of minimizing the number of access tracts of PCNL while simultaneously improving the one-step stone-free rate (SFR). The aim of this study was to share the experience of the consecutive 200 cases of ECIRS in one institute and analyze surgical outcomes of mini-ECIRS and standard ECIRS. Materials and Methods: We performed ECIRS for 200 adult patients between July 2017 and January 2020. An ECIRS was performed with the patient under general anesthesia in the intermediate-supine position. Surgeries were finished using a tubeless technique with a simple ureteral stent insertion. Results: There were significant differences in the mean maximal stone length (MSL), the variation coefficient of stone density (VCSD), the linear calculus density (LCD), the Seoul National University Renal Stone Complexity (S-ReSC), and the modified S-ReSC scores in stone characteristics, and estimated blood loss (EBL) and operation time in peri-operative outcomes between conventional and mini-ECIRS. After propensity-score matching, there was only a difference in EBL between the two groups. In logistic regression models, MSL [odds ratio (OR) 0.953; 95% confidence interval (CI) 0.926–0.979; p < 0.001], LCD (OR 4.702; 95% CI 1.613–18.655; p = 0.013) were significant factors for the success rate after ECIRS. Conclusions: In patients who underwent a mini-ECIRS, the stones were relatively smaller and less complex, and the operation time was shorter. However, if the size of stones was similar, there was no difference in the success rate, but EBL was lower in mini-ECIRS than in standard surgery.

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Comparison of mini endoscopic combined intrarenal surgery and multitract minimally invasive percutaneous nephrolithotomy specifically for kidney staghorn stones: a single-centre experience

Cited by 6 publications

References 38 publications

Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi: a prospective randomized controlled study

The Consecutive 200 Cases of Endoscopic-Combined Intrarenal Surgery: Comparison between Standard and Miniature Surgeries

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