Mohamed Mahmoud Abdelfatah Zaza, Ahmed Mohamed Tawfeek, Tarek Abd El-Mageed Salem, Muhammad Ibrahim Salim Soliman, Mohammed Hassan Ali
{"title":"逆行肾内手术后结石残留的风险因素:前瞻性队列研究","authors":"Mohamed Mahmoud Abdelfatah Zaza, Ahmed Mohamed Tawfeek, Tarek Abd El-Mageed Salem, Muhammad Ibrahim Salim Soliman, Mohammed Hassan Ali","doi":"10.1177/03915603231222083","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection.</p><p><strong>Methods: </strong>This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications.</p><p><strong>Results: </strong>A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m<sup>2</sup>. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; <i>p</i> = 0.002), multiple stones (OR = 13.62, <i>p</i> = 0.002), stone size of 21-30 mm (OR = 4.91, <i>p</i> = 0.038), lower calyx site (OR = 4.85, <i>p</i> = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, <i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"550-557"},"PeriodicalIF":0.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors of stone residual after retrograde intrarenal surgery: A prospective cohort study.\",\"authors\":\"Mohamed Mahmoud Abdelfatah Zaza, Ahmed Mohamed Tawfeek, Tarek Abd El-Mageed Salem, Muhammad Ibrahim Salim Soliman, Mohammed Hassan Ali\",\"doi\":\"10.1177/03915603231222083\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection.</p><p><strong>Methods: </strong>This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications.</p><p><strong>Results: </strong>A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m<sup>2</sup>. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; <i>p</i> = 0.002), multiple stones (OR = 13.62, <i>p</i> = 0.002), stone size of 21-30 mm (OR = 4.91, <i>p</i> = 0.038), lower calyx site (OR = 4.85, <i>p</i> = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, <i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.</p>\",\"PeriodicalId\":23574,\"journal\":{\"name\":\"Urologia Journal\",\"volume\":\" \",\"pages\":\"550-557\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urologia Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/03915603231222083\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/03915603231222083","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/9 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Risk factors of stone residual after retrograde intrarenal surgery: A prospective cohort study.
Background: Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection.
Methods: This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications.
Results: A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m2. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; p = 0.002), multiple stones (OR = 13.62, p = 0.002), stone size of 21-30 mm (OR = 4.91, p = 0.038), lower calyx site (OR = 4.85, p = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, p = 0.020).
Conclusions: This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.