Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones

Tonyalı, Şenol; Yılmaz, Mehmet Emin; Karaaslan, Mustafa; Ceylan, Cavit; Işıkay, Levent

doi:10.5152/tud.2018.88615

Cited by 26 publications

(15 citation statements)

References 23 publications

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“…likely to have residual stones after fURS compared to patients having stones at other locations (35). Evidently, the spontaneous passing of stone fragments after the surgery was more difficult due to the position of the lower pole.…”

Section: Discussionmentioning

confidence: 98%

“…Compared to middle and upper pole stones, the fURS treatment of lower pole stones is more complicated because of the anatomical factors and the limited deflection angle of flexible ureteroscopes ( 34 ). Additionally, Tonyali et al reported that patients with lower pole stones are 2.25 times more likely to have residual stones after fURS compared to patients having stones at other locations ( 35 ). Evidently, the spontaneous passing of stone fragments after the surgery was more difficult due to the position of the lower pole.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Clinical-Radiomics Model Pre-operatively Predicted the Stone-Free Rate of Flexible Ureteroscopy Strategy in Kidney Stone Patients

et al. 2020

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The purpose of the study is to develop and validate a novel clinical-radiomics nomogram model for pre-operatively predicting the stone-free rate of flexible ureteroscopy (fURS) in kidney stone patients. Patients and Methods: Altogether, 2,129 fURS cases with kidney stones were retrospectively analyzed, and 264 patients with a solitary kidney stone were included in a further study. For lower calyx calculi, a radiomics model was generated in a primary cohort of 99 patients who underwent non-contrast-enhanced computed tomography (NCCT). Radiomics feature selection and signature building were conducted by using the least absolute shrinkage and selection operator (LASSO) method. Multivariate logistic regression analysis was employed to build a model incorporating radiomics and potential clinical factors. Model performance was evaluated by its discrimination, calibration, and clinical utility. The model was internally validated in 43 patients. Results: The overall success rate of fURS was 72%, while the stone-free rate (SFR) for lower calyx calculi and non-lower calyx calculi was 56.3 and 90.16%, respectively. On multivariate logistic regression analysis of the primary cohort, independent predictors for SFR were radiomics signature, stone volume, operator experience, and hydronephrosis level, which were all selected into the nomogram. The area under the curve (AUC) of clinical-radiomics model was 0.949 and 0.947 in the primary and validation cohorts, respectively. Moreover, the calibration curve showed a satisfactory predictive accuracy, and the decision curve analysis indicated that the nomogram has superior clinical application value. Conclusion: In this novel clinical-radiomics model, the radiomics scores, stone volume, hydronephrosis level, and operator experience were crucial for the flexible ureteroscopy strategy.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

A Novel Clinical-Radiomics Model Pre-operatively Predicted the Stone-Free Rate of Flexible Ureteroscopy Strategy in Kidney Stone Patients

et al. 2020

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“…The R.I.R.S scoring system consisted of stone density, stone in the lower pole with infundibulopelvic angle < 30 o , infundibulum length, and stone burden 9 . One study by Tonyali et al proposed that the lower pole stone location and the use of a ureteral access sheath were significant factors 10 .…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy

Pattarawongpaiboon¹,

Usawachintachit²

2021

Insight Urol

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Objective: Flexible ureterorenoscopy (fURS) is one of the standard treatments for renal calculi up to 20 mm. This study aims to identify factors associated with stone-free status. Materials and Methods: We included patients undergoing fURS for treatment of small to medium-size renal stone (no single stone larger than 20 mm) from April 2017 to September 2019 at King Chulalongkorn Memorial Hospital. All patients had a preoperative CT scan and postoperative imaging for comparison. We collected patient characteristics (sex, age, previous ipsilateral urinary tract surgery, preoperative ureteral stent placement), stone factors (total stone burden, stone number, stone density) and renal factors (anatomical abnormalities, stone location in a lower pole, number of caliceal involvement) and correlated the data against postoperative stone-free status (defined as residual fragment ≤ 2 mm). Results: The overall stone-free rate was 53.3%. From the univariate analysis, previous surgery, total stone burden, stone number, stone location in the lower pole, and the number of caliceal involvement were associated with stone-free status. However, only the total stone burden remained statistically significant in the multivariate analysis (p-value < 0.05). The stone-free rates were 75.9%, 57.1%, and 11.1% in the total stone burden ≤ 10 mm, 11-20 mm, > 20 mm, respectively. Conclusion: Following treatment of renal stones ≤ 20 mm with fURS, the stone-free rate was 53.3% and was significantly associated with the preoperative total stone burden.

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“…Many studies have investigated factors that predict stone‐free and surgical success. In some studies, stone size, presence of lower pole calculi, surgical experience, presence of hydronephrosis, and UAS use are significant predictors of RIRS outcomes, while others have only found the number of stones and the number of sites to be significant 17‐19 . Particularly because of the advances in the field of lasers, stone access is the most important factor in making treatment possible.…”

Section: Discussionmentioning

confidence: 99%

The effect of optical dilatation before retrograde intrarenal surgery on success and complications: Results of the RIRSearch group study

et al. 2021

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Aim:The guidelines propose optical dilatation before retrograde intrarenal surgery (RIRS), but there are currently no evidence-based studies concerning the impact of optical dilatation with semirigid ureteroscopy (sURS). The aim of this study was to evaluate the effect of optical dilatation through sURS prior to the RIRS procedure on the success and complications of RIRS.Methods: A total of 422 patients were included in the retrospective multicentre study. The patients were divided into two groups according to whether sURS was to be performed. Patients' demographics, stone parameters and operative outcomes were compared. Surgical success was defined as no or up to 3-mm residual stone fragments without the need for additional procedures. The independent predictors for surgical success were determined with a multivariable logistic regression model. Results:Of the 422 patients, 133 (31.5%) were in the sURS group and 289 (68.5%) were in the non-sURS group. Stone characteristics and patients' demographics were similar between the groups. Operation time in the sURS group was significantly longer (compared with the non-sURS group, P < .0001). A ureteral access sheath (UAS) could not be placed in four (3.0%) patients in the sURS group, nor in 25 (8.7%) patients in the non-sURS group (P = .03). Compared with the non-sURS group, the intraoperative complication rate was lower in the sURS group (14 [4.8%] vs 1 [0.8%], P = .04).The surgical success rate was higher in the sURS group (P = .002). Nevertheless, sURS had no independent effect on surgical success. We found two independent predictors for surgical success rate: stone number (P < .0001, OR:2.28) and failed UAS placement (P = .035, OR:3.49). Conclusions:Optical dilatation with sURS before RIRS increases surgical success by raising the rate of UAS placement and reducing the rate of intraoperative complications. We suggest that this method can be routinely applied to patients who have not been passively dilated with a JJ stent. How to cite this article: Sancak EB, Basatac C, Akgul HM, et al. The effect of optical dilatation before retrograde intrarenal surgery on success and complications: Results of the

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Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones

Abstract: Stone volume could be a more reliable parameter than stone size in predicting RIRS success. Lower pole stone location and UAS use could be considered the most significant predictors of SFS after single session RIRS for single renal stones.

Cited by 26 publications

References 23 publications

A Novel Clinical-Radiomics Model Pre-operatively Predicted the Stone-Free Rate of Flexible Ureteroscopy Strategy in Kidney Stone Patients

A Novel Clinical-Radiomics Model Pre-operatively Predicted the Stone-Free Rate of Flexible Ureteroscopy Strategy in Kidney Stone Patients

Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy

The effect of optical dilatation before retrograde intrarenal surgery on success and complications: Results of the RIRSearch group study

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