Evaluating the Safety of Retrograde Intrarenal Surgery (RIRS) : Intra- and Early Postoperative Complications in Patients Enrolled in the Global Multicentre Flexible Ureteroscopy Outcome Registry (FLEXOR)
Giulioni, Carlo (Università Politecnica delle Marche)
Fuligni, D. (Università Politecnica delle Marche)
Brocca, C. (Università Politecnica delle Marche)
Ragoori, D. (Asian Institute of Nephrology & Urology)
Chew, B.H. (University of British Columbia)
Emiliani, Esteban (Institut de Recerca Sant Pau)
Heng, C.T. (Ng Teng Fong General Hospital)
Tanidir, Yiloren (Marmara University)
Gadzhiev, Nariman (Saint-Petersburg State University Hospital)
Singh, A. (Muljibhai Patel Urological Hospital)
Hamri, S.B. (King Abdullah International Medical Research Center)
Soehabali, B. (Abdul Wahab Sjahranie Hospital)
Galosi, A.B. (Università Politecnica delle Marche)
Tailly, T. (Universitair Ziekenhuis Gent)
Traxer, O. (Sorbonne University)
Somani, B.K. (University Hospitals Southampton)
Wroclawski, M.L. (Hospital Israelita Albert Einstein (Sao Paolo, Brasil))
Gauhar, Vineet (Ng Teng Fong General Hospital)
Castellani, D. (Università Politecnica delle Marche)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Purpose: To assess the incidence of the most common intra- and early postoperative complications following RIRS in a large series of patients with kidney stones. Methods: We conducted a retrospective analysis of patients with kidney stones who underwent RIRS across 21 centers from January 2018 to August 2021, as part of the Global Multicenter Flexible Ureteroscopy Outcome (FLEXOR) Registry. Results: Among 6669 patients undergoing RIRS, 4. 5% experienced intraoperative pelvicalyceal system bleeding without necessitating blood transfusion. Only 0. 1% of patients, required a blood transfusion. The second most frequent intraoperative complication was ureteric injury due to the ureteral access sheath requiring stenting (1. 8% of patients). Postoperatively, the most prevalent early complications were fever/infections requiring antibiotics (6. 3%), blood transfusions (5. 5%), and sepsis necessitating intensive care unit admission (1. 3%). In cases of ureteric injury, a notably higher percentage of patients exhibited multiple stones and stone(s) in the lower pole, and these cases were correlated with prolonged lasing and overall surgical time. Hematuria requiring a blood transfusion was associated with an increased prevalence of larger median maximum stone diameters, particularly among patients with stones exceeding 20 mm. Furthermore, these cases exhibited a significant prolongation in surgical time. Sepsis necessitating admission to the intensive care unit was more prevalent among the elderly, concomitant with a significantly larger median maximum stone diameter. Conclusions: Our analysis showed that RIRS has a good safety profile but bleeding requiring transfusions, ureteric injury, fever, and sepsis are still the most common complications despite advancements in technology.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hematuria ; Kidney Calculi ; Sepsis
Publicat a:	International Braz J Urol, Vol. 50 Núm. 4 (july 2024) , p. 459-469, ISSN 1677-6119

DOI: 10.1590/S1677-5538.IBJU.2024.0055
PMID: 38743064

11 p, 198.1 KB

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