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Inicio Actas Urológicas Españolas (English Edition) Flexible ureteroscopy for renal stones
Journal Information
Vol. 38. Issue 9.
Pages 571-575 (November 2014)
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Vol. 38. Issue 9.
Pages 571-575 (November 2014)
Original article
Flexible ureteroscopy for renal stones
Tratamiento de la litiasis renal mediante ureteroscopia flexible
Visits
355
M. Cepeda
Corresponding author
marcoscepedadelgado@yahoo.es

Corresponding author.
, J.H. Amón, J.A. Mainez, V. Rodríguez, D. Alonso, J.M. Martínez-Sagarra
Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, Spain
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Tables (3)
Table 1. Inclusion criteria.
Table 2. Demographic variables of the lithiasis.
Table 3. Results.
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Abstract
Objectives

The objectives of this prospective study are to present our experience with retro-grade intrarenal surgery (RIRS), and to analyze its results and complications.

Materials and methods

150 patients with renal stones were treated with RIRS. 111 cases showed single stones whilst multiple stones were observed in 39 cases. The mean size was 19.12mm (r: 5–74). Success rate was defined as the absence of residual stones or the presence of fragments ≤2mm.

Results

In 21 (14%) patients RIRS could not be performed on first attempt because it was impossible to place the ureteral access sheath. The immediate success rate was 85.7% and 91.6% at three months later. The average operating time was 85min (r: 25–220). Postoperative complications were observed in 22 cases (14.6%), although most of them were classified as Clavien 1 and 2 (19 cases), and only 2% (3 cases) showed Clavien 4 complications (sepsis requiring admission in the intensive care unit). 10 patients underwent a second procedure in order to complete the treatment. Thus, the number of procedures per patient was 1.06. There were nolate complications.

Conclusions

The treatment of renal stones with flexible ureteroscopy using the ureteral access sheath shows a high successful rate with a low complication rate. In order to define its indication more precisely, randomized studies comparing RIRS with minimally invasive percutaneous nephrolithotomy procedures (miniperc and microperc) would be necessary.

Keywords:
Renal lithiasis
Flexible ureteroscopy
Retrograde intrarenal surgery
Resumen
Objetivos

Presentamos en este trabajo prospectivo nuestra experiencia con la cirugía retró-grada intrarrenal (CRIR), analizando sus resultados y las complicaciones.

Material y métodos

Hemos tratado 150 pacientes afectados de litiasis renal mediante CRIR. Lalitiasis fue única en 111 casos y múltiple en 39, siendo el tama¿no medio de 19,12mm (r: 5-74). Definimos éxito en nuestra serie como la ausencia de litiasis o fragmentos residuales menoresde 2mm.

Resultados

En 21 pacientes (14%) no pudo realizarse la CRIR en un primer intento por imposi-bilidad de ascenso de la vaina ureteral. La tasa de éxito inmediata fue del 85,7% y a los 3 mesesdel 91,6%. El tiempo medio operatorio fue 85min (r: 25-220). En el postoperatorio inmediatohubo complicaciones en 22 pacientes (14,6%), si bien la mayoría de ellas fueron Clavien 1 y 2(19 casos) y solo un 2% sufrió complicaciones Clavien 4 (3 casos de sepsis que precisaron ingresoen la unidad de cuidados intensivos). En 10 pacientes se precisó una segunda intervención paracompletar el tratamiento, por lo que el número de procedimientos por paciente fue de 1,06. No hubo complicaciones tardías.

Conclusiones

El tratamiento de la litiasis renal mediante ureteroscopia flexible obtiene unatasa alta de éxito con bajas complicaciones. Precisamos estudios aleatorizados que la comparencon la nefrolitectomía percutánea, en sus modalidades menos invasivas (miniperc y microperc) para definir con exactitud sus indicaciones.

Palabras clave:
Litiasis renal
Ureteroscopia flexible
Cirugía retrógrada intrarrenal

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