Retrograde intra-renal surgery for stone extraction.
OBJECTIVE
To assess various clinical parameters affecting the efficacy and safety profile of retrograde intra-renal surgery (RIRS) for stone extraction.


METHODS
Between the years 2001 and 2003, 63 patients underwent RIRS in our department for renal calculi, including 25 who had stones >/=20mm in size.


RESULTS
Among the 63 patients who underwent the operation, 19 (30%) had infectious complications postoperatively. Although neither preoperative stenting nor stone burden were found to have any direct implication on postoperative course, a trend was seen as 64% of the infected patients had initially had large renal stones (>/=20mm in diameter) and 59% had been preoperatively drained.


CONCLUSIONS
RIRS is currently considered to be a safe standard retrograde endoscopic procedure for treating renal calculi. However, patients with stones>20 mm in diameter or multiple small calculi, especially in the presence of pre-existing tubes or following prior urinary tract infections, represent a subgroup of patients that are, in general, at higher risk of remarkable infectious complication rates and are likely to experience less satisfying stone-free rates when RIRS surgery is performed.
Zilberman
Dorit E
DE
Section of Endourology, Department of Urology, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. dorit1e@yahoo.com
Mor
Yoram
Y
Duvdevani
Mordechai
M
Ramon
Jacob
J
Winkler
Harry Z
HZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*