Safety and Efficacy of Retrograde Intrarenal Surgery in the Solitary Kidney: A Propensity Score–Matched Analysis of the RIRSearch Study Groups’ Results


Cinar O., Cakir H., Ozman O., Akgul M., Basatac C., SIDDIKOĞLU D., ...More

Journal of Laparoendoscopic and Advanced Surgical Techniques, vol.34, no.2, pp.155-161, 2024 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 34 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.1089/lap.2023.0408
  • Journal Name: Journal of Laparoendoscopic and Advanced Surgical Techniques
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, MEDLINE
  • Page Numbers: pp.155-161
  • Keywords: renal calculi, retrograde intrarenal surgery, solitary kidney, surgical success
  • Çanakkale Onsekiz Mart University Affiliated: Yes

Abstract

Background: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in patients with renal calculi with solitary kidneys (SKs). Materials and Methods: In this retrospective, multicenter study, a matched case–control study was carried out using the data from 522 RIRS patients treated between 2014 and 2021. Patients’ demographic data, stone characteristics, operative outcomes, perioperative and postoperative complications, and surgical success were analyzed. All patients were evaluated with noncontrast-enhanced computed tomography (NCCT) preoperatively and 1 month after the surgery. Surgical success was defined as no evidence of remaining residual fragments of <3 mm in the first-month postoperative NCCT images. The case group of 29 patients with SKs (Group 1) treated with RIRS were matched with 76 control patients (Group 2) with bilateral kidneys, who underwent unilateral RIRS by propensity score–matched (PSM) analysis. Results: After PSM analysis, the demographic and clinical data did not differ significantly between the groups. The stone burden was similar between the groups: 733.6 mm3 (range: 50.4–7565.9) versus 991.1 mm3 (range: 201.2–4380.6) (P = .09), respectively. The perioperative complication rates were 13.8% (n = 4) in Group 1 and 11.8% (n = 9) in Group 2 (P = .78). There was no statistically significant difference between the groups for postoperative complication rates (minor complications, classified as Clavien 1 or 2), (6.9% [n = 2] versus 13.2% [n = 10; P = .34]), respectively. Surgical success was 82.8% (n = 24) in Group 1 and 83.6% in Group 2 (P = .92). There was no significant difference between preoperative and postoperative glomerular filtration rate and creatinine values (P = .005). Conclusions: Our results support that RIRS is a safe and effective treatment method in SK patients with similar complication and stone-free rates compared to patients who had bilateral functional kidneys and underwent unilateral RIRS.