Muhammed Fatih Simsekoglu, Oktay Özman, Hakan Cakir, Kerem Teke, Önder Çınar, Murat Akgül, Mustafa Bilal Tuna, Cem Başataç, Eyüp Burak Sancak, Duygu Sıddıkoğlu, Cenk Yazici, Barbaros Başeskioğlu, Haluk Akpinar, Bulent Onal
{"title":"逆行肾内手术中低极结石与低无结石率有关：神话还是事实？来自 RIRSearch 小组的一项匹配病例对照研究。","authors":"Muhammed Fatih Simsekoglu, Oktay Özman, Hakan Cakir, Kerem Teke, Önder Çınar, Murat Akgül, Mustafa Bilal Tuna, Cem Başataç, Eyüp Burak Sancak, Duygu Sıddıkoğlu, Cenk Yazici, Barbaros Başeskioğlu, Haluk Akpinar, Bulent Onal","doi":"10.1159/000541253","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>There are conflicting results in the literature regarding the efficacy of retrograde intrarenal surgery (RIRS) in lower pole stones. This study aimed to evaluate RIRS outcomes in lower pole stones by forming matched case-control groups.</p><p><strong>Methods: </strong>The data of 491 patients who were diagnosed with kidney stones and underwent RIRS were retrospectively included in the study. A total of 209 patients with lower pole stones (Group 1) and 282 patients with pelvic stones (Group 2) were matched at a 1:1 ratio in terms of stone burden, stone density, preoperative double-J stenting status, and a previous history of shock wave lithotripsy, yielding 159 patients in each group. A computed tomography scan was performed to evaluate the stone-free status. The primary outcome was stone-free status 1 month after RIRS.</p><p><strong>Results: </strong>After case-control matching, the median age was 49 years (interquartile range [IQR]: 40-58) in Group 1 and 50 years (IQR: 35-60) in Group 2 (p = 0.388). The median stone burden values of Group 1 and Group 2 were 415.3 mm3 (IQR: 176.1-858.2) and 503.3 mm3 (IQR: 282.5-864), respectively (p = 0.100). After RIRS, stone-free status was achieved by 126 of the 159 (79.2%) in Group 1 and 133 of the 159 (83.6%) patients in Group 2 (p = 0.387). The groups were similar in terms of perioperative complications (4.4% in Group 1 and 3.8% in Group 2, p = 0.777), postoperative complications (13.8% in Group 1 and 10.3% in Group 2, p = 0.393), and median operation time (60 min in both, p = 0.230). A longer median fluoroscopy time was noted in Group 1 compared to Group 2 (26 s and 3 s, respectively, p = 0.013).</p><p><strong>Conclusions: </strong>Stone-free rates and complications were comparable between the patients with lower pole and pelvic stones after RIRS. However, lower pole stones are associated with longer fluoroscopy time. RIRS can be performed effectively for the treatment of lower pole stones.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lower Pole Stones Are Associated with Low Stone-Free Rates in Retrograde Intrarenal Surgery: A Myth or Fact? - A Matched Case-Control Study from the RIRSearch Group.\",\"authors\":\"Muhammed Fatih Simsekoglu, Oktay Özman, Hakan Cakir, Kerem Teke, Önder Çınar, Murat Akgül, Mustafa Bilal Tuna, Cem Başataç, Eyüp Burak Sancak, Duygu Sıddıkoğlu, Cenk Yazici, Barbaros Başeskioğlu, Haluk Akpinar, Bulent Onal\",\"doi\":\"10.1159/000541253\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>There are conflicting results in the literature regarding the efficacy of retrograde intrarenal surgery (RIRS) in lower pole stones. This study aimed to evaluate RIRS outcomes in lower pole stones by forming matched case-control groups.</p><p><strong>Methods: </strong>The data of 491 patients who were diagnosed with kidney stones and underwent RIRS were retrospectively included in the study. A total of 209 patients with lower pole stones (Group 1) and 282 patients with pelvic stones (Group 2) were matched at a 1:1 ratio in terms of stone burden, stone density, preoperative double-J stenting status, and a previous history of shock wave lithotripsy, yielding 159 patients in each group. A computed tomography scan was performed to evaluate the stone-free status. The primary outcome was stone-free status 1 month after RIRS.</p><p><strong>Results: </strong>After case-control matching, the median age was 49 years (interquartile range [IQR]: 40-58) in Group 1 and 50 years (IQR: 35-60) in Group 2 (p = 0.388). The median stone burden values of Group 1 and Group 2 were 415.3 mm3 (IQR: 176.1-858.2) and 503.3 mm3 (IQR: 282.5-864), respectively (p = 0.100). After RIRS, stone-free status was achieved by 126 of the 159 (79.2%) in Group 1 and 133 of the 159 (83.6%) patients in Group 2 (p = 0.387). The groups were similar in terms of perioperative complications (4.4% in Group 1 and 3.8% in Group 2, p = 0.777), postoperative complications (13.8% in Group 1 and 10.3% in Group 2, p = 0.393), and median operation time (60 min in both, p = 0.230). A longer median fluoroscopy time was noted in Group 1 compared to Group 2 (26 s and 3 s, respectively, p = 0.013).</p><p><strong>Conclusions: </strong>Stone-free rates and complications were comparable between the patients with lower pole and pelvic stones after RIRS. However, lower pole stones are associated with longer fluoroscopy time. RIRS can be performed effectively for the treatment of lower pole stones.</p>\",\"PeriodicalId\":23414,\"journal\":{\"name\":\"Urologia Internationalis\",\"volume\":\" \",\"pages\":\"1-9\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urologia Internationalis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000541253\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Internationalis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000541253","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Lower Pole Stones Are Associated with Low Stone-Free Rates in Retrograde Intrarenal Surgery: A Myth or Fact? - A Matched Case-Control Study from the RIRSearch Group.
Introduction: There are conflicting results in the literature regarding the efficacy of retrograde intrarenal surgery (RIRS) in lower pole stones. This study aimed to evaluate RIRS outcomes in lower pole stones by forming matched case-control groups.
Methods: The data of 491 patients who were diagnosed with kidney stones and underwent RIRS were retrospectively included in the study. A total of 209 patients with lower pole stones (Group 1) and 282 patients with pelvic stones (Group 2) were matched at a 1:1 ratio in terms of stone burden, stone density, preoperative double-J stenting status, and a previous history of shock wave lithotripsy, yielding 159 patients in each group. A computed tomography scan was performed to evaluate the stone-free status. The primary outcome was stone-free status 1 month after RIRS.
Results: After case-control matching, the median age was 49 years (interquartile range [IQR]: 40-58) in Group 1 and 50 years (IQR: 35-60) in Group 2 (p = 0.388). The median stone burden values of Group 1 and Group 2 were 415.3 mm3 (IQR: 176.1-858.2) and 503.3 mm3 (IQR: 282.5-864), respectively (p = 0.100). After RIRS, stone-free status was achieved by 126 of the 159 (79.2%) in Group 1 and 133 of the 159 (83.6%) patients in Group 2 (p = 0.387). The groups were similar in terms of perioperative complications (4.4% in Group 1 and 3.8% in Group 2, p = 0.777), postoperative complications (13.8% in Group 1 and 10.3% in Group 2, p = 0.393), and median operation time (60 min in both, p = 0.230). A longer median fluoroscopy time was noted in Group 1 compared to Group 2 (26 s and 3 s, respectively, p = 0.013).
Conclusions: Stone-free rates and complications were comparable between the patients with lower pole and pelvic stones after RIRS. However, lower pole stones are associated with longer fluoroscopy time. RIRS can be performed effectively for the treatment of lower pole stones.
期刊介绍：
Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
