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

Gauhar, Vineet; Traxer, Olivier; Fuligni, Demetra; Brocca, Carlo; Galosi, Andrea Benedetto; Teoh, Jeremy Yuen‐Chun; Castellani, Daniele

doi:10.1097/mou.0000000000001106

Cited by 3 publications

(1 citation statement)

References 38 publications

(191 reference statements)

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“…Endoscopic combined intrarenal surgery (ECIRS) was first reported in 2008 [ 27 ]. With the introduction of disposable flexible ureteroscopes and lithotripsy equipment, ECIRS has become a revolutionary approach for treating kidney stones due to its higher one-step SFR and lower morbidity compared to PNL alone [ 12 , 28 ]. Hamamoto et al [ 29 ] evaluated the ECIRS technique in the prone split-leg (PSL) position for the treatment of staghorn calculi and found it to be a safe and effective approach without increasing the number of percutaneous tracts.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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Models to predict the surgical outcome of mini-ECIRS (endoscopic combined intrarenal surgery) for renal and/or ureteral stones

Ito,

Sakamaki,

Fukuda

et al. 2023

Sci Rep

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To establish a safer and more efficient treatment strategy with mini-endoscopic combined intrarenal surgery (ECIRS), the present study aimed to develop models to predict the outcomes of mini-ECIRS in patients with renal and/or ureteral stones. We retrospectively analysed consecutive patients with renal and/or ureteral stones who underwent mini-ECIRS at three Japanese tertiary institutions. Final treatment outcome was evaluated by CT imaging at 1 month postoperatively and stone free (SF) was defined as completely no residual stone or residual stone fragments ≤ 2 mm. Three prognostic models (multiple logistic regression, classification tree analysis, and machine learning-based random forest) were developed to predict surgical outcomes using preoperative clinical factors. Clinical data from 1432 ECIRS were pooled from a database registered at three institutions, and 996 single sessions of mini-ECIRS were analysed in this study. The overall SF rate was 62.3%. The multiple logistic regression model consisted of stone burden (P < 0.001), number of involved calyces (P < 0.001), nephrostomy prior to mini-ECIRS (P = 0.091), and ECOG-PS (P = 0.110), wherein the area under the curve (AUC) was 70.7%. The classification tree analysis consisted of the number of involved calyces with an AUC of 61.7%. The random forest model showed that the top predictive variable was the number of calyces involved, with an AUC of 91.9%. Internal validation revealed that the AUCs for the multiple logistic regression model, classification tree analysis and random forest models were 70.4, 69.6 and 85.9%, respectively. The number of involved calyces, and a smaller stone burden implied a SF outcome. The machine learning-based model showed remarkably high accuracy and may be a promising tool for physicians and patients to obtain proper consent, avoid inefficient surgery, and decide preoperatively on the most efficient treatment strategies, including staged mini-ECIRS.

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First Worldwide Multicentric Series of Mini-Ecirs in Children: Outcomes from two Tertiary Endourology Centers

Quiroz,

Ferretti,

Campobasso

et al. 2024

Journal of Endourology

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

Cited by 3 publications

References 38 publications

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

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

Models to predict the surgical outcome of mini-ECIRS (endoscopic combined intrarenal surgery) for renal and/or ureteral stones

First Worldwide Multicentric Series of Mini-Ecirs in Children: Outcomes from two Tertiary Endourology Centers

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