title: Retrograde intrarenal surgery with holmium-YAG laser lithotripsy in the primary treatment of renal lithiasis.
abstract: BACKGROUND
  retrograde intrarenal surgery (RIRS) appears as a safe and effective technique as well as a good therapeutic alternative to extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL).
  
  
  METHODS
  descriptive study in 50 patients surgically treated between November 2012 and April 2013. Demographic, operative and postoperative data as well as early and late complications data were collected. The minimum follow-up of patients was one year. Surgery was performed under general anesthesia. Flexible ureteroscopy with ureteral access sheath and laser fragmentation were employed. Surgery success was defined as stone free rate in postoperative control test and at three months after surgery (simple radiography, abdominal ultrasound or CT without contrast).
  
  
  RESULTS
  mean age was 51.1±15.5 years old. The highest-frequency location was the lower calyceal group (26%), single stones were described in 58% of patients whilst multiple lithiasis were found in the 42%. Regarding the stone burden in 44% of the patients was low (<2 cm), and high (>3 cm) in 22% of the patients. The stone clearance rate was 89.7±17.5. Average surgery time was 96.6±35.2min. Complications were reported in 4 patients (8%), all of them early ones and minor in nature.
  
  
  CONCLUSIONS
  RIRS is an effective and safe option whose results are comparable to ESWL and PCNL. RIRS can be considered as first-line treatment. These results are corroborated by numerous studies. To strengthen these findings, prospective studies focusing on quality of life, length of stay, complications and cost-effectiveness of different treatments are needed.
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Redondo
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España. Electronic address: frfata@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Ramón de Fata
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España.
authors.forename: H
authors.initials: H
authors.lastname: Gimbernat
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Meilán
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España.
authors.forename: G
authors.initials: G
authors.lastname: Andrés
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Angulo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D018666:Ureteroscopy; D055815:Young Adult
keywords: Cirugía retrógrada intrarrenal; Flexible ureteroscopy; Litiasis renal; Renal lithiasis; Retrograde intrarenal surgery; Ureteroscopia flexible