Ureteroscopy-assisted Versus Conventional Ultrasound-Guided Renal Access for Miniaturised Endoscopic Combined Intrarenal Surgery: A Multicentre Comparative Study

You have accessJournal of UrologyStone Disease: Surgical Therapy II (MP18)1 Sep 2021MP18-18 URETEROSCOPY-ASSISTED VERSUS CONVENTIONAL ULTRASOUND-GUIDED RENAL ACCESS FOR MINIATURIZED ENDOSCOPIC COMBINED INTRARENAL SURGERY: A MULTICENTER COMPARATIVE STUDY Kazumi Taguchi, Shimpei Yamashita, Shuzo Hamamoto, Ryusuke Deguchi, Kengo Kawase, Tomoki Okada, Rei Unno, Taiki Kato, Ryosuke Ando, Atsushi Okada, Yasuo Kohjimoto, Isao Hara, and Takahiro Yasui Kazumi TaguchiKazumi Taguchi More articles by this author , Shimpei YamashitaShimpei Yamashita More articles by this author , Shuzo HamamotoShuzo Hamamoto More articles by this author , Ryusuke DeguchiRyusuke Deguchi More articles by this author , Kengo KawaseKengo Kawase More articles by this author , Tomoki OkadaTomoki Okada More articles by this author , Rei UnnoRei Unno More articles by this author , Taiki KatoTaiki Kato More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Yasuo KohjimotoYasuo Kohjimoto More articles by this author , Isao HaraIsao Hara More articles by this author , and Takahiro YasuiTakahiro Yasui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002003.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endoscopic combined intrarenal surgery (ECIRS) is a good treatment option for large kidney stones. Although direct vision from the ureteroscope is considered an advantage, the efficacy of ureteroscopy-assisted puncture (UAP) for percutaneous renal access remains unclear. To assess the impact and availability of UAP during ultrasound-guided miniaturised (mini)-ECIRS for large volume renal and/or proximal ureteral stones. METHODS: Patients who underwent mini-ECIRS for treatment of renal and/or ureteral stones in the two academic centers from January 2016 to April 2020. We compared the surgical outcomes between UAP and conventional ultrasound-guided (cUSG) mini-ECIRS. The primary outcome was set for stone-free rate (SFR), and the secondary outcomes were additional surgical intervention, total procedure and fluoroscopy duration, and complication rates. We performed statistical analyses using Two-sample t tests, Mann-Whitney U test, and Fisher exact as well as logistic and linear regression for multivariate evaluation. RESULTS: There were 197 and 127 patients in the cUSG and UAP groups, respectively. The UAP group had a higher SFR at 3 months post-operation and lower additional surgical intervention rate than the cUSG group (59.1 vs 43.5%, p=0.008; 6.3 vs 19.6%, p=0.001, respectively). Multivariate analyses revealed that UAP was associated with decreased chances of additional surgical intervention (odds ratio=0.34, p=0.013) and post-operative infection (odds ratio=0.32, p=0.002) and decreased total procedure (estimate= -12 minutes, p=0.008), fluoroscopy (estimate=-3.1 minutes, p=0.027), and post-operative ureteral stent placement (estimate=-8 minutes, p=0.009) durations (Table 1). Moreover, women and those with a smaller stone volume or without hydronephrosis were identified as ideal candidates for UAP. CONCLUSIONS: UAP during mini-ECIRS could provide favorable surgical outcomes and was more likely to produce favorable outcomes in women without obstruction of the collecting system. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e325-e325 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazumi Taguchi More articles by this author Shimpei Yamashita More articles by this author Shuzo Hamamoto More articles by this author Ryusuke Deguchi More articles by this author Kengo Kawase More articles by this author Tomoki Okada More articles by this author Rei Unno More articles by this author Taiki Kato More articles by this author Ryosuke Ando More articles by this author Atsushi Okada More articles by this author Yasuo Kohjimoto More articles by this author Isao Hara More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement Loading ...