逆行性腎臟內視鏡碎石手術：初步經驗

黃文齊¹、郭威廷^1、2、3、吳振宇^1、2、林嘉祥^1、2

¹義大醫療財團法人義大醫院 泌尿科；

²義守大學 醫學系，³化學工程學系暨生物科技與化學工程研究所

Retrograde intrarenal surgery for renal stone: initial experience

Vincent Wen-Chi Huang¹, Wade Wei Ting Kuo^1,2,3, Richard Chen Yu Wu^1,2, Victor C. Lin^1,2

Department of Urology¹, E-Da Hospital, Kaohsiung, Taiwan;

School of Medicine, College of Medicine², I-Shou University, Kaohsiung, Taiwan

Institute of Biotechnology and Chemical Engineering³, I-Shou University, Kaohsiung, Taiwan

Purpose:

Renal stone is a common disease with overall prevalence 7.38% and overall recurrence rate 34.71% at 5 years in Taiwan. Modern treatment modalities for renal stone include extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). This study aimed to present current outcome of RIRS at our institution.

Materials and Methods:

This retrospective study enrolled patients who had renal stones receiving RIRS in 2020, with subgroup divided by mean cumulative stone burden (<10mm, 10-20mm and >20mm). Inclusion criteria was patients who have renal stone(s) with renal colic. Exclusion criteria was patients with untreated urinary tract infection, coagulopathy, urinary tract abnormality or pregnancy. Primary outcome was stone free rate (SFR). Secondary outcomes included overall complication rate, major complication rate, post-procedure stay and retreatment rate.

Results:

There were total 56 patients enrolled in this study with 45 unilateral and 11 bilateral RIRS performed. Mean cumulative stone burden was 24.5mm and mean maximum stone size was 18.6mm. The overall SFR was 43.3%. SFR for subgroup of lower pole stones was 44.4% and mean stone burden between 10 to 20mm was 55.6% respectively. The overall complication rate was 21.1%, among which Clavien-Dindo classification IVa was 1.8% and IVb was 3.5%. Mean post-procedure stay was 3.2 days. The retreatment rate was 16.4%.

Conclusions:

RIRS provides a relatively safe method and acceptable SFR for resolving renal stones. However, further investigation was needed to improve the outcome of SFR.