Retrograde intrarenal surgery for renal stones - Part 2

Kılıç, Özcan; Akand, Murat; B, Van Cleynenbreugel

doi:10.5152/tud.2017.22697

Cited by 25 publications

(13 citation statements)

References 61 publications

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“…Nevertheless, fURS can provide higher stone-free rates compared with minimally invasive percutaneous procedures. In our study, the overall rates of SF of fURS process was about 72%, which is consistent with other studies (ranging between 65 and 92%) (32). However, in the subgroup analysis based on location, the SF rate for the lower calyx calculi only reached 56.3%, which was obviously lower than the figure for the non-lower calyx calculi (90.16%).…”

Section: Discussionsupporting

confidence: 90%

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: Discussionsupporting

confidence: 90%

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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“…With the continuous improvement of flexible ureteroscope equipment, such as endoscope miniaturization, improved deflection angles, enhanced optical quality, and ancillary tools, more and more urologists have become inclined to use retrograde intrarenal surgery (RIRS) to treat kidney stones [ 1 , 2 ]. Although the current urolithiasis guidelines recommend RIRS for renal stones smaller than 20 mm, with the accumulation of experience of the surgeon and the preoperative judgment of the difficulty of the operation, more surgeons have engaged RIRS to resolve renal stones larger than 20 mm and achieved excellent results [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

Wang

2021

BMC Urol

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Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

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“…Retrograde intrarenal surgery (RIRS) is rapidly becoming an effective and safe treatment modality in the surgical treatment of urinary system stone disease[1]. Small kidney stones and upper urinary tract tumours can be effectively treated by RIRS using minimally invasive methods[2]. RIRS was first reported for the treatment of small kidney stones in 2002.…”

Section: Introductionmentioning

confidence: 99%

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

Li¹,

Yang²,

Liu³

et al. 2018

WJCC

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AIMTo compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of 1.5-2.5 cm.METHODSA total of 216 patients who underwent mini-PCNL (n = 103) or RIRS n = 113) for LP stones with a diameter of 1.5-2.5 cm were enrolled between December 2015 and April 2017 at the Urology Department of Ningbo Urology and Nephrology Hospital.RESULTSSignificant differences were found in the hospital stay (9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs (2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operation time was not significantly different between the RIRS group (56.48 ± 24.77) and the mini-PCNL group (60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day (RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively (RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different.CONCLUSIONRIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment for LP stones of 1.5-2.5 cm.

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Retrograde intrarenal surgery for renal stones - Part 2

Cited by 25 publications

References 61 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

External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

Retrograde intrarenal surgery vs miniaturized percutaneous nephrolithotomy to treat lower pole renal stones 1.5-2.5 cm in diameter

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