Factors affecting the success and perioperative complications of retrograde intrarenal surgery: a retrospective clinical analysis

Sarwar Noori  Mahmood; Dler Fathulla  Abdalla; Choman Jamal  Ahmed

doi:10.56056/amj.2024.256

Authors

Sarwar Noori Mahmood Professor of Urology, University of Sulaymania- College of medicine, KRG, Iraq.
Dler Fathulla Abdalla KBMS/ Urology trainee, Sulaymania general teaching hospital, KRG, Iraq.
Choman Jamal Ahmed FIBMS, Sulaymania general teaching hospital, KRG, Iraq.

DOI:

https://doi.org/10.56056/amj.2024.256

Keywords:

Flexible ureteroscopy lithotripsy, Renal stone disease, RIRS, Retrograde intrarenal surgery

Abstract

Background and objective:

Many factors are presumed to have an impact on the results of retrograde intra renal surgery. In the current study, our objective was to actuate the possible factors influencing the stone-free rates and complications post lone-session retrograde intrarenal surgery for renal calculi. Stone-free rates

Methods: Overall 200 patients who undergone retrograde intra renal surgery between January 2019 and March 2022 were evaluated, retrospectively. Success was decided if there were no residual fragments on pain X-ray and ultrasonography. Patient demographics, stone characteristics, perioperative data were assessed and analyzed to actuate predictive factors influencing stone-free rates and perioperative morbidities.

Results: Two hundred patients with a mean age of 41.12±14.37 years were evaluated. The mean stone size was 1.815 ± 2.107 millimeters (mm), mean stone density was 969.63 ± 345.307 Hounsfield unit. The immediate SFR was (76.8±0.42) while the final SFR (single session) was 87.9±0.46. Thirty-seven patients (18.5%) developed complications, the preponderance of them 86% were minor complications (Clavien grade I and II). In multivariate regression analysis, multiple renal stones and ureteral access sheath use were constitute to be statically significant predictors of stone-free status. Moreover, multivariate regression analysis revealed that operative time, lasing time and stone opacity stones were statistically significant factors influencing perioperative complications.

Conclusion: Success rates inversely related to stones number and ureteral access sheath usage. While prolonged operation time, lasing time, and higher stone density could be a more reliable predictor of perioperative complication development.

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