Is It a Good Strategy to Proceed a Retrograde Intrarenal Surgery Session Sheathless After Ureteral Access Sheath Insertion Failure? A RIRSearch Study

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dc.authoridDEMIRBILEK, MUHAMMET/0000-0003-1056-1103
dc.authoridOZMAN, Oktay/0000-0003-2499-8947
dc.authoridOnal, Bulent/0000-0003-0540-2693
dc.authoridcinar, onder/0000-0002-0107-5843
dc.contributor.authorOzman, Oktay
dc.contributor.authorCinar, Onder
dc.contributor.authorCakir, Hakan
dc.contributor.authorBasatac, Cem
dc.contributor.authorAkgul, Haci Murat
dc.contributor.authorDemirbilek, Muhammet
dc.contributor.authorSancak, Eyup Burak
dc.date.accessioned2024-10-29T17:58:37Z
dc.date.available2024-10-29T17:58:37Z
dc.date.issued2023
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractObjectives: To complement our previous findings regarding effect of ureteral access sheath (UAS) use, we checked RIRSearch database for patients who operated without using UAS. The aim of the study was to understand these new data better by comparing outcomes of retrograde intrarenal surgery (RIRS) that continued sheathless after a failed UAS insertion vs those planned and completed sheathless.Materials and Methods: Data of 195 patients who underwent sheathless RIRS for kidney and/or ureteral stones between 2011 and 2021 were retrieved from the database. Patients divided into two groups: cases who were planned and completed sheathless (n = 110, Group 1) and those who proceeded without UAS after insertion failure (n = 85, Group 2). After propensity score matching (PSM), each group consisted of 76 patients.Results: After PSM, stone-free rate for Group 1 (90.8%) was significantly higher than stone-free rate of Group 2 (76.3%) in sheathless RIRS (p = 0.02). Also postoperative complication rate was significantly lower in Group 1 (10.5%) than in Group 2 (27.6%) (p = 0.007). In Group 2, median operating time was longer (60 minutes, interquartile range [IQR]: 40-80) and more unplanned auxilliary procedure (22.4%) was needed than Group 1 (45 minutes, IQR: 40-50 and 3.9%) (both p = 0.001). Stone burden (odds ratio [OR]: 1.002, p = 0.019) and stone density (OR: 1.002, p = 0.003) were associated with high risk of residual stones after RIRS. Higher hydronephrosis grades were associated with increased stone-free rates (OR: 0.588 for residual stone risk, p = 0.024). Cases who completed sheathless by dusting all available stones, as planned preoperatively, were more likely to have stone-free status after RIRS than those who proceeded sheathless after UAS insertion failure (OR: 2.645, p = 0.024).Conclusions: Operation course after UAS insertion failure may be more challenging. In cases who performed without using UAS, surgeons who proceed with procedure sheathless after UAS insertion failure may more frequently run into complications and may fail achieving stone-free status compared with sheathless-planned cases.
dc.identifier.doi10.1089/end.2022.0599
dc.identifier.endpage752
dc.identifier.issn0892-7790
dc.identifier.issn1557-900X
dc.identifier.issue7en_US
dc.identifier.pmid37021344
dc.identifier.startpage747
dc.identifier.urihttps://doi.org/10.1089/end.2022.0599
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14421
dc.identifier.volume37
dc.identifier.wosWOS:000981110700001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMary Ann Liebert, Inc
dc.relation.ispartofJournal of Endourology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectkidney stone
dc.subjectretrograde intrarenal surgery
dc.subjectureteral access sheath
dc.subjectstone-free rate
dc.titleIs It a Good Strategy to Proceed a Retrograde Intrarenal Surgery Session Sheathless After Ureteral Access Sheath Insertion Failure? A RIRSearch Study
dc.typeArticle

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