Retrograde Intrarenal Surgery for Stone Disease under Spinal Anaesthesia, a Minimally Invasive Technique. A Retrospective Analysis of 1467 Cases

Introduction and objectivesThe aim of the present study was to compare RIRS procedures applied under general anaesthesia (GA) and spinal anaesthesia (SA) regarding success and complication rates.Materials and methodsA retrospective evaluation was conducted with the data obtained from patients treated with RIRS under SA and GA at 2 centres from October 2014 until January 2018. The SA and GA groups were evaluated according to the parameters of stone-free and complication rates, postoperative pain control and length of in-hospital stay. The stone-free rates from the RIRS procedures applied with SA were evaluated by the surgeons who participated in the study.ResultsA total of 1361 patients were included in the study. A stone-free rate of 84.4% was obtained in the global results: 85.3% in the SA group and 83.5% in the GA group (p=0.364). No statistically significant difference was determined regarding surgeons who practiced RIRS under SA with respect to success/complication rates and operating time (p=0.676). Operation time was determined as 44.2±14.2min in the SA group and 49.7±19.1min in the GA group (p=0.014).ConclusionsThe RIRS method can be applied safely, either under spinal anaesthesia, or under general anaesthesia. The success of RIRS under spinal anaesthesia has been shown as an independent factor regarding surgeon. It can be considered a good alternative to general anaesthesia.