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    Does the 5-Item Modified Frailty Index Predict Adverse Outcomes after Retrograde Intrarenal Surgery? A Case-Control Study by the RIRSearch Group
    (Mary Ann Liebert, Inc, 2025) Basatac, Cem; Simsekoglu, Muhammed Fatih; Teke, Kerem; Tuna, Mustafa Bilal; Cinar, Oender; Akguel, Haci Murat; Oezman, Oktay
    Objectives: We aim to assess whether severely frail patients have an increased risk of complications and worse surgical outcomes after retrograde intrarenal surgery. Methods: The data of 340 consecutive patients undergoing retrograde intrarenal surgery to treat upper tract urinary stones were analyzed retrospectively. The 5-item modified frailty index (mFI-5) was used to assess the frailty status. Using a cutoff value of score 2 in the mFI-5 score, patients were divided into two groups: patients with an mFI-5 score <2 were assigned to a non-frail (Group 1) group, and patients with an mFI-5 score >= 2 were assigned to a frail (Group 2) group. The patients' demographics, stone characteristics, operative outcomes, and complication rates were compared between the groups. The primary objective was to examine whether the surgical outcomes were much better in non-frail patients. Results: After matching confounding factors, Group 1 comprised 255 patients, and Group 2 comprised 85 patients. The baseline characteristics were similar between the groups. There were no statistically significant differences in terms of the median operation time and length of hospital stay among groups. There were no significant differences between groups for intraoperative complication rates (7.6% and 9.4%, respectively; P = .47) and postoperative complication rates (13.8% and 11.8%, respectively; P = .71), and stone-free rates (70.9% versus 72.9%, respectively; P = .73). Conclusions: Retrograde intrarenal surgery is an efficient and feasible treatment option for upper urinary tract stones in severely frail patients.
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    Safety and Efficacy of Live Retrograde Intrarenal Surgery in Patients with Kindey Stone: Outcomes from a Boutique Course Series Which Complies with the Live Surgery Event Policies
    (Iniestares, S.A., 2023) Ozman, Oktay; Citgez, Sinharib; Basatac, Cem; Akguel, Haci Murat; Kalender, Goektug; Yazici, Cenk Murat; Tanidir, Yiloeren
    Background: Live surgery events (LSEs) are frequently organized for sharing the surgical experiences with surgeons at the beginning of their learning curves. The aim of this study was to investigate whether the outcomes and complication rates of patients underwent retrograde intrarenal surgery (RIRS) at LSEs are comparable with regular cases. Methods: Ten courses were organized during 2017-2022. Data of 32 patients who operated in the LSEs were 1:3 matched (for stone burden and surgeon) with the data of patients who underwent regular RIRS within the course periods at the same centers (n = 96). All courses took place in concordance with the latest LSE policies. The primary outcomes were stone-free and complication rates. Fluoroscopy and operation times were the secondary outcomes. Results: Stone-free rates of the groups were similar (84% in LSE and 79% in control group; p = 0.520). Similarly, there were no differences in complication rates (p = 0.428) and fluoroscopy time (p = 0.477). Duration of the LSE cases (82.24 +/- 31.12 min) was slightly but insignificantly longer than regular cases (73.77 +/- 20.89 min, p = 0.092). Moreover, guest surgeons tend to have longer operation time with statistically insignificant prolongation (74.92 +/- 30.43 min for host, 89.52 +/- 28.34 min for guest surgeons, p = 0.064). Conclusions: RIRS can be performed without jeopardizing operation efficiency and patient safety in LSEs. If surgeon is not familiar with operating room set-up or staff, live surgery must be performed by host surgeon to avoid extended operating time.