The efficacy of retrograde intra-renal surgery (RIRS) for lower pole stones: results from 2946 patients

• DOI: 10.1007/s00345-023-04363-6
• Publication Date: 2023-03-17T13:02:57Z
• Authors: Carlo Giulioni; Daniele Castellani; Bhaskar Kumar Somani; Ben Hall Chew; Thomas Tailly; William Ong Lay Keat; Jeremy Yuen‑Chun ...; Esteban Emiliani; Chu Ann Chai; Andrea Benedetto ...; Deepak Ragoori; Yiloren Tanidir; Saeed Bin Hamri; Nariman Gadzhiev; Olivier Traxer; Vineet Gauhar
• Keywords: Nephrology; Concomitant; Postoperative fever

To evaluate the perioperative outcomes of retrograde intra-renal surgery (RIRS) for lower pole stones (LPS) and factors affecting stone-free rate (SFR).Data from 20 centers were retrospectively reviewed. Inclusion criteria adult patients, normal renal anatomy, LPS. Exclusion bilateral surgery, concomitant ureteral stones. SFR was defined as a single residual fragment (RF) ≤ 2 mm evaluated 3-months after surgery. A multivariable logistic regression analysis performed to assess associated with RF. Statistical significance set at p value < 0.05.2946 patients included. Mean age stone size 49.9 years 10.19 mm, multiple LPS in 61.1% cases. Total operation laser time 63.89 ± 37.65 17.34 18.39 min, respectively. hospital stay 3.55 days. Hematuria requiring blood transfusion fever/urinary infections prolonged antibiotics occurred 6.1% 169 5.7% cases, while sepsis intensive-care admission 1.1% patients. On multivariate analysis, Multiple (OR 1.380), 1.865), reusable ureteroscopes 1.414) significantly RF, Thulium fiber (TFL) 0.341) pre-stenting 0.750) less likely RF.RIRS showed safety efficacy mean diameter 10 mm. This procedure can achieve satisfactory pre-stented smaller stone, particularly TFL use.