scholarly journals The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery

BMC Urology ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Yinglong Xiao ◽  
Deng Li ◽  
Lei Chen ◽  
Yaoting Xu ◽  
Dingguo Zhang ◽  
...  
Keyword(s):  
Scoring System ◽  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Wang ◽  
ShouTong Wang ◽  
Xuemei Wang ◽  
Jun Lu
Keyword(s):  
Scoring System ◽  
Kidney Stone ◽  
Medical Center ◽  
External Validation ◽  
Retrograde Intrarenal Surgery ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate ◽  
Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stone

2020 ◽  
Author(s):  
Mehmet Cagatay Cicek ◽  
Tariq Asi ◽  
Kadir Omur Gunseren ◽  
Hakan Kilicarslan
Keyword(s):  
Operation Time ◽  
Retrograde Intrarenal Surgery ◽  
Median Hospital Stay ◽  
Efficient Procedure ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Median Hospital ◽  
Free Rate

Abstract Background To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones. Methods This study included patients who presented with a single renal pelvic stone sized ≥20 mm and who were treated primarily by laparoscopic pyelolithotomy or retrograde intrarenal surgery. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis and the surface area of the stone, operation time, hospitalization time, complications and stone-free rates of the two groups. Results Of the 156 patients included in the study, 44 had laparoscopic pyelolithotomy, and 112 had retrograde intrarenal surgery. Patients who received laparoscopic pyelolithotomy (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent retrograde intrarenal surgery (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received laparoscopic pyelolithotomy were found to have larger median stone size (30 mm vs 24 mm, p=0.003), longer operation time (100 minutes vs 70 minutes, p=0.007), lower complication rate (2% vs 8.9%, p=0.063), longer median hospital stay (3 days vs 1 day, p<0.001) and better stone-free rate at the third month (90.9% vs 67.9%, p<0.001). Conclusion LP is a safe and efficient procedure that could be used as an alternative to retrograde intrarenal surgery in managing large renal pelvic stones.

scholarly journals Factors Impacting Stone-Free Rate After Retrograde Intrarenal Surgery for Calyceal Diverticular Calculi

2020 ◽  
Vol Volume 12 ◽  
pp. 345-350
Author(s):  
Chatporn Boonyapalanant ◽  
Pat Saksirisampant ◽  
Tawatchai Taweemonkongsap ◽  
Sunai Leewansangtong ◽  
Sittiporn Srinualnad ◽  
...  
Keyword(s):  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Free Rate

Percutaneous-Based Management of Staghorn Calculi in Solitary Kidney: Combined Mini Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery

2014 ◽  
Vol 94 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Wen Zhong ◽  
Zhijian Zhao ◽  
Liang Wang ◽  
Sunil Swami ◽  
Guohua Zeng
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Solitary Kidney ◽  
Retrograde Intrarenal Surgery ◽  
Staghorn Calculi ◽  
Combined Use ◽  
Stone Free Rate ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

Introduction: Mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are well-established techniques with little morbidity. The combined use of standard PCNL and the mini-PCNL or the RIRS technique was evaluated and compared to investigate their own role in the management of staghorn calculi in solitary kidney. Materials and Methods: 23 patients received combined standard PCNL and mini-PCNL (group 1), and 22 patients received combined standard PCNL and RIRS (group 2). The treatment results and complications were evaluated and compared. Results: The mean operation time was 128.8 ± 9.1 min in group 1 and 109.8 ± 10.7 min in group 2 (p < 0.001). The decrease in hemoglobin level in group 1 was significantly higher than that in group 2 (3.5 ± 0.6 vs. 2.1 ± 0.5 g/dl, p < 0.001). The final stone-free rate was significantly higher (p = 0.038) in group 2 (90.9%) than in group 1 (65.2%). Conclusions: Combined standard PCNL and RIRS technique can extract the majority of staghorn calculi quickly by PCNL with EMS Lithoclast, and RIRS used simultaneously can reduce the need for multiple tracts and therefore reduce blood loss and potential morbidity related to multiple tracts, shorten the operation time and achieve a high stone-free rate.

Retrograde Intrarenal Surgery in Treatment of Nephrolithiasis: Is a 100% Stone-Free Rate Achievable?

2012 ◽  
Vol 26 (5) ◽  
pp. 489-493 ◽  
Author(s):  
Martin Schoenthaler ◽  
Konrad Wilhelm ◽  
Arndt Katzenwadel ◽  
Peter Ardelt ◽  
Ulrich Wetterauer ◽  
...  
Keyword(s):  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals Stone free rate and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS): Our experience in 571 consecutive cases

2021 ◽  
Vol 93 (3) ◽  
pp. 313-317
Author(s):  
Orazio Maugeri ◽  
Ettore Dalmasso ◽  
Dario Peretti ◽  
Fabio Venzano ◽  
Germano Chiapello ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Urinary Stones ◽  
Flexible Ureteroscopy ◽  
Safe Procedure ◽  
Retrograde Intrarenal Surgery ◽  
Stone Size ◽  
Clinical Complications ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Free Rate

Introduction: The purpose of this study is to report the stone free rate (SFR) and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS). Materials and methods: A total of 571 procedures of upper urinary stones treated using flexible ureteroscopy and holmium laser lithotripsy from January 2014 to February 2020 have been analyzed. Overall SFR was evaluated after 3 months following the procedure by means of a non-contrast computed tomography. Success was considered as stone-free status or ≤ 0.4 cm fragments. Results: The overall SFR was 92.3% in group 1 (stone size: < 1 cm), 88.3% in group 2 (stone size: > 1 ≤ 2 cm), 56.7% in group 3 (stone size: 2-3 cm) and 69.6% in group 4 (multiple stones). Post-operative complications, according to the Clavien- Dindo (CD) classification system, were recorded in 32 (5.6%) procedures. The major complications recorded were: one case of subcapsular hematoma (SRH) associated with pulmonary embolism two days after the procedure (CD Grade IIIa) treated conservatively and one case of hemorrhagic shock 2 hour with multiple renal bleedings requiring urgent nephrectomy (CD Grade IVA). Conclusions: The RIRS is an effective and safe procedure with a high SFR significantly correlated with the stone size; at the same time, RIRS could be characterized by severe clinical complications that require rapid diagnosis and prompt treatment.

scholarly journals Split-leg percutaneous nephrolithotomy: A safe and versatile technique

2013 ◽  
Vol 85 (2) ◽  
pp. 82 ◽  
Author(s):  
Eugenio Di Grazia ◽  
Pasquale La Rosa
Keyword(s):  
Ct Scan ◽  
Urinary Stones ◽  
Flexible Ureteroscopy ◽  
Surgical Time ◽  
Retrograde Intrarenal Surgery ◽  
Stone Size ◽  
Stone Free Rate ◽  
Versatile Technique ◽  
Hemoglobin Drop ◽  
Free Rate

Objectives: Percutaneos nephrolithotomy (PCNL) is the gold standard for treatment of urinary stones larger than 2 cm and refractory to ESWL. Nowadays most debate about surgical technique is related to the positioning of patients. We report our expe- rience on prone PCNL with split-leg variant (SL-PCNL) Materials and methods: 30 consecutive patients underwent prone SL-PCNL. Preoperative stone size was deter- mined by measuring stones longest diameter on CT scan. In cases with multiple stones, stone size was determined by the sum of each stone diameter on CT scan. Patients evaluated con- sisted of 20 females and 10 males and median age was 55 (20-72). The average BMI was 27 (24-35). 15 patients had multiple stones, 10 pyelocalicial, 10 pelvic larger than 2 cm, 2 in horseshoe kidneys and 3 staghorn stones. Results: Stone free rate was 87% after first look and 97% after second look. In 2 cases, we used a flexible ureteroscopy 7.5 Fr (Flex 2 - Storz) to treat a calculus in ureter or for a contemporary double access (Endoscopic combined Retrograde Intrarenal Surgery ECIRS). In 28 cases we placed a 20 fr nephrostomy while in two cases procedure was tubeless. In 20 cases we placed a double-J catheter. In 2 cases we performed two tract and in 2 horseshoe kidneys access was close to spine. The average surgical time was about 90 minutes (range 30-120 minutes). Hemoglobin drop was about 1.5 mg/dl (range 1-3 .4 mg/dl) and no major complications were reported. Conclusions: In our experience PCNL in prone with spread-legs variant is a versatile technique and allows to match the advantages you have with same technique in supine, providing at the same time benefits in cases of anatomical abnormalities, challenging cases, or when multi-tract accesses are required.

scholarly journals Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kehua Jiang ◽  
Fa Sun ◽  
Jianguo Zhu ◽  
Guangheng Luo ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Scoring System ◽  
Meta Analysis ◽  
Scoring Systems ◽  
Lower Proportion ◽  
Systematic Evaluation ◽  
Cochrane Library ◽  
Stone Free Rate ◽  
The Cochrane Library ◽  
Staghorn Stone ◽  
Free Rate

Abstract Background Clinical studies assessing the feasibility and accuracy of three stone scoring systems’s (SSSs: Guy’s stone score, CROES nomogram and S.T.O.N.E nephrolithometry scoring system) have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and accuracy of three SSSs. Methods A systematic search of Embase, Pubmed, Medline, and the Cochrane Library was conducted to identify studies that compared three SSSs up to Mar 2018. Patients were categorized according to stone free (SF) and no-stone free (NSF), Outcomes of interest included perioperative variables, stone-free rate (SFR), and complications. Results Ten studies estimating three SSSs were included for meta-analysis. The results showed that SF patients had a significantly lower proportion of male (OR = 1.48, P = 0.0007), lower stone burden (WMD = -504.28, P < 0.0001), fewer No of involved calyces (OR = -1.23, P = 0.0007) and lower proportion of staghorn stone (OR = 0.33, P < 0.0001). Moreover, SF patients had significantly lower score of Guy score (WMD = -0.64, P < 0.0001), but, S.T.O.N.E. score (WMD = -1.23, P < 0.0001) and a higher score of CROES nomogram (WMD = 29.48, P = 0.003). However, the comparison of area under curves (AUC) of predicting SFR indicated that there was no remarkable difference between three SSSs. Nonetheless, Guy score was the only stone scoring system that predicted complications after PCNL (WMD = -0.29, 95% CI: − 0.57 to − 0.02, P = 0.03). Conclusions Our meta-analysis indicated that the three SSSs were equally, feasible and accurate for predicting SFR after PCNL. However, Guy score was the only stone scoring system that predicted complications after PCNL.

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