Retrograde intrarenal surgery for kidney diseases


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Abstract

Introduction. Retrograde intrarenal surgery (RIRS) is being actively implemented in the treatment of renal stones and other diseases. If necessary, RIRS can be combined with percutaneous procedures. Aim. To study the results of RIRS in patients with nephrolithiasis and various renal disorders. Materials and methods. A total of 106 patients who undergone RIRS were included in the study. There were 66 men (63.4%) and 40 women (36.6%). Mean age was 46.8+15.6 years. The indication for RIRS in 84 (79.2%) patients was renal stones. Calculus in calyceal diverticulum were diagnosed in 6 (5.7%), encrusted stents in 8 (7.7%), urinary fistulas after partial nephrectomy in 5 (4.7%), pelvis tumors in 2 (1.9%), pelvis perforation after marsupialization of parapelvic cyst in 1 (0.9%) patient, respectively. Simultaneous retro- and antegrade procedures were performed in 27 (25.5%) cases. In those with nephrolithiasis and encrusted stents, lithotripsy was done with the removal of stone fragments. Two patients underwent endoscopic resection of the pelvis tumor. In six patients, the neck of the diverticulum was incised after lithotripsy, while in five cases retrograde endoscopically controlled percutaneous treatment urinary fistulae was performed. In one case, laser fulguration of the pelvis defect with stenting was done. Results. RIRS was effective in 72 (85.7%) of 84 patients with renal stones. The operation time was 70.8+10.2 minutes. In 12 (14.3%) cases with residual fragments, extracorporeal shock-wave lithotripsy (я=7) and repeated RIRS (я=5) were performed. The efficiency of RIRS after two sessions was 91.7%. Complications were observed in 11 (10.4%) patients. With encrusted stents, the operation time was 95.0+16.5 min. After laser fragmentation of encrustations in the lower part of the stent, percutaneous lithotripsy was performed with antegrade removal of its upper half. The time for RIRS in those with diverticula was 60.0+8.5 min, the average stone size was 8 mm (from 6 to 10 mm). In all cases lithotripsy with mucosal fulguration was successfully done. The procedures for urinary fistulae were also effective (operation time was 45.0 + 20.5 minutes) and there were no complications. Conclusion. RIRS is a safe and effective treatment for patients with nephrolithiasis and other kidney disorders. Modern flexible ureteroscopes allows to examine the collecting system and to perform lithotripsy and removal of stone fragments.

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About the authors

B. G Guliyev

NorthWestern State Medical University named after I.I. Mechnikov; Center of Urology with robot-assisted surgery of City Mariinsky hospital

Email: gulievbg@mail.ru
Ph.D., MD, professor, professor at the department of urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Head of Center of Urology with robot-assisted surgery of City Mariinsky hospital Saint Petersburg

B. K Komyakov

NorthWestern State Medical University named after I.I. Mechnikov

Email: komyakovbk@mail.ru
Ph.D., MD, professor, Head of the Department of Urology Saint Petersburg

M. U Agagyulov

NorthWestern State Medical University named after I.I. Mechnikov

Ph.D. student at the Department of Urology Saint Petersburg

Kh. Kh Yagubov

NorthWestern State Medical University named after I.I. Mechnikov; Center of Urology with robot-assisted surgery of City Mariinsky hospital

Ph.D. student at the Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, physician at the Center of Urology with robot-assisted surgery of City Mariinsky hospital Saint Petersburg

E. I Korol

Center of Urology with robot-assisted surgery of City Mariinsky hospital

physician Saint Petersburg

A. E Talyshinsky

NorthWestern State Medical University named after I.I. Mechnikov

Email: alima@mail.ru
resident at the Department of Urology Saint Petersburg

References

  1. Аполихин О.И., Сивков А.В., Комарова В.А., Просянников М.Ю., Голованов М.Ю. Заболеваемость мочекаменной болезнью в Российской Федерации (2005-2016). Экспериментальная и клиническая урология. 2018;4(4):4-14
  2. Hill A.J., Basourakos S.P., Lewicki P., Wu X., Arenas-Gallo C. et al. Incidence of kidney stones in the United States: the continuous national health and nutrition examination survey. J Urol. 2022;207(4):851-856. Doi: 10.1097/ JU.00000000000002331
  3. Мартов А.Г., Дутов С.В., Попов С.В., Емельяненко А.В., Андронов А.С. и соавт. Микроперкутанная лазерная нефролитотрипсия. Урология. 2019;3:72-79. Doi: 10.18565/ urology.2019.3.72-79
  4. De Sio M., Manfredi С., Fusco А., Greta М., Mirone V., Arcaniolo D. Recent advances in percutaneous lithotripsy techniques. Curr Opin Urol. 2021;31(1):24-28. doi: 10.1097/M0U.0000000000000829.
  5. Desai J., Shah H.N. Mini percutaneous kidney stone removal: applicable technologies. Urol. Clin North Am. 2022;49(1): 161-173. Doi: 10.1016/j. ucl.2021.08.003.
  6. Schoenthaler M., Wilhelm K., Katzenwadel A,. Ardelt P., Wetterauer U., Traxer O. et al. Retrograde intrarenal surgery in treatment of nephrolithiasis: is a 100% stone-free rate achievable? J Endourol. 2012;26:489-493. Doi: 10.1089/ end.2011.0405.
  7. Guisti G., Proietti S., Villa L., Cloutier J., Rosso M. et al. Current standard technique for modern flexible ureteroscopy: Tips and tricks. Eur Urol. 2016;70:188-194. doi: 10.1016/j.eururo.2016.03.035.
  8. Scoffone C.M., Cracco C.M. Unvited review: the tale of endoscopic combined intrarenal surgery in the Galdakao-modofied supine Valdivia position. Urolothiasis. 2018;46:115-123. doi: 10.1007/s00240-017-1015-9.
  9. Tawfeek A.M., Elmoazen M., Saafan A, Higazy A, Radwan A, Gad H.H. Simultaneous antegrade and retrograde endourological approach in Galdakaomodified supine Valdivia position for the management of missed stents associated with complex renal stones: a non-randomized pilot study.Intern Urol. Nephrol. 2021;53(2):211-217. doi: 10.1007/s11255-020-02639-z
  10. Turk C., Petrik A., Sarica K., Seitz C., Skolarikos A. et al. EAU guidelines on interventional treatment for urolithiasis. Eur Urol. 2016;69(3):475-482. doi: 10.1016/j.eururo.2015.07.041.
  11. Григорьев Н.А. Ретроградная интраренальная хирургия: современный взгляд проблемы. Урология. 2018;5:175-181. Doi: 10.18565/ urology.2018.5.175-181
  12. Климов Р.Е., Лекарев В.Ю., Цариченко Д.Г., Дымов А.М. и соавт. Ретроградная интраренальная хирургия с использованием суперимпульсного тулиевого волоконного лазера в волной длиной 1,94 мкм. Урология. 2021;1:28-32. doi: 10.18565/urology.2021.1.28-32
  13. Erkurt B., Kiremit M.C., Altay B. et al. Is retrograde flexible nephrolithotripsy feasible for calyceal diverticular stone? Urolithiasis. 2014;42:347-351. doi: 10.1007/s00240-014-0672-1
  14. Samson P., Smith A.D., Hoeing D., Okeke Z. Endoscopic management of upper urinary tract urothelial carcinoma. J Endourol. 2018;32(S1):S10-16. doi: 10.1089/end.2018.0036.
  15. Lavan L., Herrmann T., Netsch C., Becker B., Somani B.K. Outcomes of ureteroscopy for stone disease in anomalius kidneys: a systematic review. World J Urol. 2020;38:1135-1145. doi: 10.1007/s00345-019-02810-x
  16. Гулиев Б.Г., Король Е.И., Авазханов Ж.П., Ягубов Х.Х, Агагюлов М.У., Талышинский А.Э. Эндоскопически ретроградно контролируемое перкутанное лечение мочевых свищей после парциальной нефрэктомии. Онкоурология. 2021;2:128-138. doi: 10.17650/1726-9776-2021-17-2128-138
  17. Zhao F., Li J., Tang L., Li Ch. A comparative study of endoscopic combined intrarenal surgery in rhe galdakao-modified supine valdivia position and minimally invasive percutaneous nephrolithotomy for complex nephrolithiasis: a retorospective single-center study. Urolithiasis. 2020;49(2): 161-166. doi: 10.1007/s00240-020-01207-5.
  18. Tonyali S., Yilmaz M., Karaaslan M., Ceylan C., I§ikay L. Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones. // Turk J Urol. 2018;44(6):473-477. doi: 10.5152/tud.2018.88615
  19. Danilovic A., Cavalanti A, Rocha B.A., Traxer O., Torricelli F.C. et al. Assessment of residual fragments after retrograde intrarenal surgery. J Endourol. 2018;32(912):1108-1113. doi: 10.1089/end.2018.0529.
  20. York N.E., Zheng M., Elmansy H.M., Rivera M.E., Krambeck A.E., Lingeman J.E. Stone-free outcomes of flexibly ureteroscopy for renal calculi utilizing computer tomography imaging. Urology. 2019;124:52-56. Doi: 10.1016/j. urology.2018.09.005.
  21. Parikh K.P., Jain R.J., Kandarp A.P. Is retrograde intrarenal surgery the game changer in the management of upper tract calculi? A single-center singlesurgeon experience of 131 cases. Urol Annals. 2018;10:29-34. Doi: 10.4103/ UA.UA_118_17.
  22. Lim S.H., Jeong B.C., Seo S.I., Jeon S.S., Han D.H. Treatment outcomes of retrograde intrarenal surgery for renal stones and predictive factors of stone-free. Korean J Urol. 2010;51:777-782. doi: 10.4111/kju.2010.51.11.777.
  23. Ito H, Kawahara T, Terao H, Ogawa T, Yao M. et al. The most reliable preoperative assessment of renal stone burden as a predictor of stone-free status after flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. Urology. 2012;80:524-528. doi: 10.1016/j.urology.2012.04.001.
  24. Гулиев Б.Г., Черемисин В.М., Талышинский А.Э. Влияние анатомии нижней группы чашечек почек на риск резидуальньи фрагментов при лечении мочекаменной болезни. Вестник урологии. 2019;7(3):5-13. doi: 10.21886/2308-64242019-7-3-5-13
  25. Karim S.S., Hanna L., Geraghty R., Somano B.K. Role of pelvicalyceal anatomy in the outcomes of retrograde intrarenal surgery for lower pole stones: outcomes with a systematic review of literature. Urolithiasis. 2020;48:263-270. doi: 10.1007/s00240-019-01150-0
  26. Martin F., Hoarau N., Lebdai S., Pichon T., Chautard D., Culty T. et al. Impact of lower pole calculi in patients undergoing retrograde intrarenal surgery. J Endourol. 2014;28:141-145. doi: 10.1089/end.2013.0515.
  27. Martov A.G., Ergakov D.V., Andronov A.S., Dutov S.V. et al. Solitary stones of the lower renal calyx: how to treat? Urology. 2017;2:28-35. Doi: 10.18565/ urol.2017.2.28-35.Russian (Мартов А.Г., Ергаков Д.В., Андронов А.С., Дутов С.В. и соавт. Одиночные камни нижней чашки почки: как лечить? Урология. 2017;2:28-35. doi: 10.18565/urol.2017.2.28-35).
  28. Bas O., Ozyuvali E., Aydogmus Y. et al. Management of calyceal diverticular calculi: a comparison of percutaneous nephrolithotomy and flexible ureterorenoscope. Urolithiasis. 2015;43:155-161. doi: 10.1007/s00240-014-0725-5.
  29. Boonyapalanant C., Saksirisampant P., Taweemonkongsap C. Factors impacting stone-free rate after retrograde intrarenal surgery for calyceal diverticular calculi. Research and Reports in Urology. 2020;12:345-350. Doi: 10.2147/ RRU.S.26959.
  30. Bradford T.J., Wolf J.S. Percutaneous injection of fibrin glue for persistent nephrocutaneous fistula after partial nephrectomy. Urology. 2005;65(4):799. doi: 10.1016/j.urology.2004.10.079.
  31. Chiu W., Chien G.M., Finley D.S. Novel ureteroscopic technique for treatment of prolonged caliceal leak after partial nephrectomy. J. Endourol. 2015;29(4):397-400. doi: 10.1089/end.2014.0441.
  32. Ward T.J., Ahmed O., Chung B.I., Sze D.Y., Hwang G.L. Percutaneous cryoablation for successful treatment of a persistent urine leak after robot-assisted partial nephrectomy. J. Vasc.Interv. Radiol. 2015;26(12):1867-1870. doi: 10.1016/j.jvir.2015.08.029.

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