Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience

Baş, Okan; Tuygun, Can; Dede, Onur; Sarı, Sercan; Çakıcı, Mehmet Çağlar; Öztürk, Ufuk; Göktuğ, Göksel; İmamoğlu, Abdurrahim

doi:10.1007/s00345-016-1930-3

Cited by 68 publications

(38 citation statements)

References 29 publications

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“…Their findings support our results, which found 35 (29.9%) patients either called or presented to an emergency department with such complaints. This contrasts to the recent reported morbidity of unilateral uretersocopy 4-13% (18)(19)(20)(21). Because of this, patients might be advised of the increased short-term morbidity associated with bilateral ureteroscopy and stenting, as compared to each episode of a staged ureteroscopy, again however, the patients are spared a second ureteroscopy which as our unilateral data would suggest carries similar risk as the first procedure.…”

Section: Discussioncontrasting

confidence: 86%

Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Ingimarsson

Rivera

Knoedler

et al. 2017

Urology

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Section: Discussioncontrasting

confidence: 86%

Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Ingimarsson

Rivera

Knoedler

et al. 2017

Urology

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Section: Introductionmentioning

confidence: 99%

“…Retrograde intrarenal surgery (RIRS) is a well‐established minimally invasive procedure in the management of renal stones . However, infection is still one of the most serious postoperative complications after RIRS, with a reported incidence of up to 25.0% . Infections can lead to a longer postoperative length of stay, higher hospital readmission rates, and the additional use of antimicrobial agents .…”

Section: Introductionmentioning

confidence: 99%

Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial

et al. 2019

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ObjectiveTo study the incidence of postoperative systemic inflammatory response syndrome (SIRS) following different antibiotic prophylaxis (ABP) regimens in retrograde intrarenal surgery (RIRS). Patients and MethodsSingle-centre, randomised, controlled trial (August 2014-September 2017) including 426 patients with renal stones with preoperative sterile urine managed by RIRS (ClinicalTrials.gov NCT02304822). Different ciprofloxacinbased ABP regimens were used and included a zero dose, single dose (30 min before surgery) or two doses (first dose at 30 min before RIRS and additional dose within 6 h after RIRS). The incidence of SIRS was compared using intentionto-treat (ITT) and per-protocol (PP) analyses. ResultsEach group enrolled 142 patients. In the ITT analysis, a zero dose of ABP was statistically similar to the two ABP regimes for the incidence of SIRS (9.9% vs single dose 4.9%, P = 0.112; vs two doses 4.2%, P = 0.062). There were also no relevant differences across groups in the PP analysis; no urosepsis was recorded. In subgroup analysis with stratification by stone area, the three regimens all had a low and similar incidence of SIRS for stones of ≤200 mm 2 in the ITT analysis with a sufficient power value (5.4% vs 6.2% vs 3.6%, P = 0.945 vs single dose and P = 0.553 vs two doses). However, there was a greater chance of SIRS in patients who received no ABP with stones of >200 mm 2 (18% vs single dose 4.3%, P = 0.036; vs two doses 5.5%, P = 0.044). Similar trends were seen in the PP analysis. ConclusionsFor patients with preoperative sterile urine, ABP is not strongly recommended in patients with stones of ≤200 mm 2 , but for stones >200 mm 2 single-dose ABP is still required.

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“…The rate of pre‐stenting in patients in currently available case series varies from 5% to 100% (Table ). The optimum duration between JJ stent insertion and UAS usage has not yet been assessed, but most authors recommend at least 5 days of pre‐stenting .…”

Section: Resultsmentioning

confidence: 99%

Systematic review of ureteral access sheaths: facts and myths

et al. 2018

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The aim of the present paper was to review the literature on all available ureteral access sheaths (UASs) with their indications, limitations, risks, advantages and disadvantages in current modern endourological practice. Two authors searched Medline, Scopus, Embase and Web of Science databases to identify studies on UASs published in English. No time period restriction was applied. All original articles reporting outcomes or innovations were included. Additional articles identified through references lists were also included. Case reports, editorials, letters, review articles and meeting abstracts were excluded. A total of 754 abstracts were screened, 176 original articles were assessed for eligibility and 83 articles were included in the review. Based on a low level of evidence, UASs increase irrigation flow during flexible ureteroscopy and decrease intrapelvic pressure and probably infectious complications. Data were controversial and sparse on the impact of UASs on multiple reinsertions and withdrawals of a ureteroscope, stone-free rates, ureteroscope protection or damage, postoperative pain, risk of ureteral strictures, and also on its cost-effectiveness. Studies on the benefit of UASs in paediatrics and in patients with a coagulopathy were inconclusive. In the absence of good randomized data, the true impact of UASs on surgery outcome remains unclear. The present review may contribute to the evidence-based decision-making process at the individual patient level regarding whether or not a UAS should be used.

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Factors affecting complication rates of retrograde flexible ureterorenoscopy: analysis of 1571 procedures—a single-center experience

Abstract: The results of the current study indicated that stone size, stone number and the presence of congenital renal abnormalities were factors affecting complication rates after FURSL, although congenital renal abnormality was the only independent predictor among these risk factors.

Cited by 68 publications

References 29 publications

Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Same-Session Bilateral Ureteroscopy: Safety and Outcomes

Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: evidence from a randomised controlled trial

Systematic review of ureteral access sheaths: facts and myths

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