Simultaneous Bilateral Endoscopic Surgery (SBES) for Bilateral Urolithiasis: the Future? Evidence from a Systematic Review

Geraghty, Robert; Jones, Patrick; Somani, Bhaskar K.

doi:10.1007/s11934-019-0877-5

Cited by 17 publications

(14 citation statements)

References 24 publications

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“…Three systematic reviews highlighted the lack of highquality evidence on BSS RIRS in the management of urolithiasis. 6,7,10 Previous retrospective series reported that SFR ranged from 42.0% to 92.8%. [11][12][13][14][15][16] This wide range reflects the different image modalities used to evaluate this outcome.…”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

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Introduction:The aim of this study was to prospectively compare the outcomes of bilateral same-session retrograde intrarenal surgery (BSS RIRS) with unilateral RIRS and to compare the outcomes of first with second operated kidneys in BSS RIRS. Subjects and Methods: Consecutive symptomatic adult patients with kidney stones up to 20 mm who accepted to be treated by RIRS were prospectively studied. Stone-free rate (SFR) was evaluated by non-contrast CT for each renal unit, and surgical complications were evaluated based on Clavien-Dindo classification. Results: SFR (73.9% vs 76.1%, p = 0.830) and hospitalization time (14.43 -18.81 hours vs 13.00 -4.89 hours, p = 0.564) were similar between unilateral and BSS RIRS groups, with less consumption of disposable devices in BSS RIRS ( p = 0.017). Operative time was longer in BSS RIRS (61.24 -26.62 minutes vs 88.65 -33.19 minutes, p < 0.001). Bilateral group had significant more overall complications by Clavien-Dindo classification than unilateral (15.9% vs 39.9%, p = 0.030) and more emergency room (ER) visits (11.6% vs 34.8%, p = 0.026). Moreover, although both groups temporarily increased creatinine levels, it was significantly higher in bilateral RIRS ( p = 0.019). First operated kidney outcomes were similar to second operated kidney outcomes of BSS RIRS. Conclusion: Although BSS RIRS had similar SFR and consumed less disposable devices, it had a higher overall complication rate, a higher frequency of ER visits, and higher creatinine levels during follow-up than unilateral RIRS. There is no significant outcome difference between first and second operated kidneys in BSS RIRS.

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Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

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“…With further digitisation of technology, reduction in scope size and improved laser fragmentation, it seems that the uptake of URS is going to increase for paediatric patients. Similarly, its role in complex patient groups or bilateral urolithiasis is likely to continue to evolve [35,36]. Recent evidence shows that outcomes for bilateral URS procedures are at least equivalent to staged procedures, minimising cost and hospital stay [36].…”

Section: Role Of Ureteroscopy (Urs)mentioning

confidence: 99%

“…Similarly, its role in complex patient groups or bilateral urolithiasis is likely to continue to evolve [35,36]. Recent evidence shows that outcomes for bilateral URS procedures are at least equivalent to staged procedures, minimising cost and hospital stay [36]. Perhaps, the paediatric urolithiasis guidelines need to address the role of access sheath, and ureteroscopy for large stones and lower pole stones.…”

Section: Role Of Ureteroscopy (Urs)mentioning

confidence: 99%

Outcomes of ureteroscopy (URS) for stone disease in the paediatric population: results of over 100 URS procedures from a UK tertiary centre

et al. 2019

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Purpose To report the outcomes of paediatric ureteroscopy (URS) for stone disease from a specialist endourology centre in the UK. Ureteroscopy for management of stone disease has increased worldwide and is now being done more commonly in the paediatric age group. Methods Data were analysed retrospectively from a database maintained between April 2010 and May 2018. Consecutive patients ≤ 16 years of age undergoing semi-rigid or flexible URS for stone disease were included. Stone size and stone-free rate (SFR) were routinely assessed using an ultrasound (USS) and/or plain KUB XR. Complications were graded according to the Clavien-Dindo classification and recorded within 30 days post-procedure and readmissions within 90 days after the procedure were also captured. Results Over the 8-year period between April 2010 and April 2018, 81 patients with a mean age of 8.8 years (range 18 months-16 years) and a male to female ratio 1:1.1 underwent 102 procedures (1.28 procedure/patient to be stone free). Of the 81 patients, 29 (35.8%) had comorbidities, with 26 (32%) having multiple comorbidities. The mean (± SEM) single and overall stone size was 9.2 mm (± 0.48, range 3-30 mm) and 11.5 mm (± 0.74, range 4-46 mm) respectively, with 22 (27.1%) having multiple stones. Thirty-five (34.7%) had stent in situ pre-operatively. The stone location was in the ureter (26.6%), lower pole (35.4%), and renal pelvis (16.5%), with 22/81(27%) having multiple stones and 21/102 (20.5%) where a ureteral access sheath (UAS) was used. With a mean hospital stay of 1.2 days, the initial and final SFR was 73% and 99%, respectively, and 61/102 (60%) had ureteric stent placed at the end of the procedure. While there were no intra-operative complications, the readmission rate was less than 1% and there were only three early complications recorded. This included a case each of prolonged admission for pain control (grade I), urinary retention (grade II) and post-operative sepsis requiring a brief ITU admission (grade IV). Conclusion Our study demonstrates that in appropriate setting a high stone-free rate can be achieved with minimal morbidity for paediatric patients. There is potentially a need to factor the increasing role of URS in future paediatric urolithiasis guidelines.

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“…For decades, simultaneous surgical treatment of bilateral renal stones has been considered a risk factor for acute renal failure and a higher incidence of complications. Notwithstanding these popular statements, some studies have shown that bilateral endoscopic interventions on the kidneys were safe not only with staged treatment from different angles [43,44] but also with a simultaneous approach [45,46]. In a series of works by R. Giusti et al on simultaneous bilateral flexible ureteronephrolithotripsy, they have described that this method was effective and safe, provided proper selection and preoperative preparation of patients.…”

Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

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Simultaneous Bilateral Endoscopic Surgery (SBES) for Bilateral Urolithiasis: the Future? Evidence from a Systematic Review

Cited by 17 publications

References 24 publications

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Prospective Evaluation of Bilateral Retrograde Intrarenal Surgery: Is It Really Safe?

Outcomes of ureteroscopy (URS) for stone disease in the paediatric population: results of over 100 URS procedures from a UK tertiary centre

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

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