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Inicio Actas Urológicas Españolas (English Edition) Is stone free status really necessary for metabolic evaluation following stone r...
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Vol. 47. Issue 10.
Pages 661-667 (December 2023)
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Vol. 47. Issue 10.
Pages 661-667 (December 2023)
Original article
Is stone free status really necessary for metabolic evaluation following stone removal procedures?
Valoración del impacto de la tasa libre de litiasis en los resultados de la evaluación metabólica
R. Guzela, C. Canakcib,
Corresponding author
cengizcanakci@hotmail.com

Corresponding author.
, B. Eryildirimb, K. Saricac
a Servicio de Urología, Hospital Medistate, Kavacık, Estambul, Turkey
b Servicio de Urología, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
c Servicio de Urología, Escuela de Medicina, Universidad de Biruni, Estambul, Turkey
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Tables (4)
Table 1. Demographic and radiologic characteristics of the cases in both groups.
Table 2. Evaluation of the pre-operative serum and urine stone forming risk factors.
Table 3. Pre- and postoperative serum and urinary stone forming risk factors in Group 1 (cases with no residual fragments-stone free cases).
Table 4. Pre- and postoperative serum and urine stone forming risk factors in Group 2 (cases with residual fragments–not stone free).
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Abstract
Objective

To evaluate the impact of stone free status on the outcomes of metabolic evaluation in recurrent stone formers after ureteroscopic stone removal.

Patients and methods

A total of 78 patients undergoing retrograde intrarenal surgery (RIRS) for renal stones were included and cases were divided into two groups after 4 weeks based on the NCCT findings. While cases in the Group 1 (n = 54) was completely stone free, cases in Group 2 (n = 24) had residual fragments in the kidney. A full 24-h urine analysis for relevant stone forming risk factors has been performed after 4 weeks following the fURS procedures in all patients of both groups. Outcomes of metabolic evaluation (24-h urine and serum) have been comparatively evaluated in both groups.

Results

Evaluation of the preoperative serum and urine stone forming risk factors revelaed no statistical difference in both groups. Comparative evaluation of the 24-h urinary stone forming risk factors also revealed no statistically significant difference between preoperative and postoperative findings in cases of Group 2 with residual stones. Last but not least, no significant difference was observed between the mean preoperative and postoperative serum variables between two groups.

Conclusions

Our results show that in the light of the similar metabolic evaluation outcomes obtained in cases with and without residual fragments, ‘stone free status’ may not be an essential factor to perform a detailed metabolic evaluation (24-h urine analysis and serum parameters) after endourological stone removal procedures.

Keywords:
Metabolic evaluation
Retrograde intrarenal surgery (RIRS)
Renal calculi
Ureteroscopy
Resumen
Objetivo

Evaluar si la tasa libre de litiasis afecta a los resultados del estudio metabólico en pacientes con alto riesgo de litiasis recidivante tras tratamiento completo mediante ureteroscopia.

Pacientes y métodos

Un total de 78 pacientes sometidos a cirugía retrógrada intrarrenal (CRIR) para el tratamiento de litiasis fueron incluidos en este estudio. Cuatro semanas después del tratamiento, los casos se dividieron en dos grupos en base a los resultados de la tomografía computarizada sin contraste (TCSC). Los casos del grupo 1 (n = 54) presentaban una tasa libre de litiasis del 100% y los del grupo 2 (n = 24) presentaban litiasis residuales en el riñón. Cuatro semanas después de la ureteroscopia flexible (URF) se realizó un análisis completo de orina de 24 h a todos los pacientes de ambos grupos, para detectar los factores de riesgo implicados en la litogénesis. Los resultados del estudio metabólico (orina de 24 h y suero) se compararon entre los dos grupos.

Resultados

La evaluación preoperatoria en orina y suero de los factores de riesgo asociados a la formación de cálculos no reveló diferencias estadísticas entre los dos grupos. El análisis comparativo de los factores de riesgo implicados en la formación de la litiasis mediante pruebas de orina de 24 h tampoco reveló diferencias estadísticamente significativas entre los resultados preoperatorios y postoperatorios en los casos del grupo 2 con cálculos residuales. Tampoco se observaron diferencias significativas entre las medias de las variables séricas preoperatorias y postoperatorias de ambos grupos.

Conclusiones

Según nuestros resultados, y dada la similitud de los hallazgos obtenidos en los estudios metabólicos de los casos con y sin litiasis residual, la tasa libre de litiasis puede no constituir un factor imprescindible para la realización del estudio metabólico detallado (suero y orina de 24 h) tras las intervenciones endourológicas para la extracción de los cálculos renales.

Palabras clave:
Estudio metabólico
Cirugía retrógrada intrarrenal (CRIR)
Litiasis renal
Ureteroscopia

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