Endoscopic Combined Intrarenal Surgery: best practices and future perspectives.

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY International Braz J Urol Pub Date : 2024-11-01 DOI:10.1590/S1677-5538.IBJU.2024.9921
Anderson B Pellanda, Fabio C M Torricelli, John Denstedt, Alexandre Danilovic, Giovanni S Marchini, Fabio C Vicentini, Carlos A Batagello, William C Nahas, Eduardo Mazzucchi
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Abstract

Introduction: Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS.

Materials and methods: A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL. Most important findings were summarized regarding indications, patient positioning, kidney access, tract size, surgical outcomes, and complications.

Results: ECIRS demonstrated higher stone-free rate, lower complication rate, and a reduced need for multiple procedures compared to traditional PCNL. Additionally, ECIRS has the potential to integrate new technologies to further enhance outcomes.

Conclusion: ECIRS demonstrates significant advantages in the management of large kidney stones. Future research should focus on well-designed RCTs to provide robust evidence of its efficacy, safety, and cost-effectiveness, potentially establishing ECIRS as the first option treatment for complex kidney stones.

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内镜联合肾内手术:最佳实践与未来展望。
导言:内镜联合肾内手术(ECIRS)已成为一种治疗大型复杂肾结石的有前途的技术,与传统的经皮肾镜取石术(PCNL)相比具有潜在优势。本研究旨在评估与 ECIRS 相关的最佳实践、结果和未来前景:从 2008 年到 2024 年,使用 MESH 术语和以下关键词对 PubMed 进行了全面搜索:"搜索共获得 157 篇文章,包括回顾性队列研究、两项随机对照试验 (RCT) 和四项比较 ECIRS 与 PCNL 的荟萃分析。对最重要的研究结果进行了总结,包括适应症、患者定位、肾脏通路、肾道大小、手术效果和并发症:结果:与传统 PCNL 相比,ECIRS 的无结石率更高,并发症发生率更低,而且减少了多次手术的需要。此外,ECIRS 还具有整合新技术以进一步提高疗效的潜力:结论:ECIRS 在治疗大块肾结石方面具有显著优势。未来的研究应侧重于设计良好的 RCT,为其疗效、安全性和成本效益提供有力的证据,从而将 ECIRS 确立为复杂肾结石的首选治疗方法。
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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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