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Can additional variables be used to predict stone-free rates following retrograde intrarenal surgery? Anticoagulants and parenchyma thickness: a detailed examination.        
Yazarlar
Doç. Dr. Ümit YILDIRIM Doç. Dr. Ümit YILDIRIM
Kafkas Üniversitesi, Türkiye
Dr. Öğr. Üyesi Mehmet EZER Dr. Öğr. Üyesi Mehmet EZER
Kafkas Üniversitesi, Türkiye
Dr. Öğr. Üyesi Mehmet USLU Dr. Öğr. Üyesi Mehmet USLU
Kafkas Üniversitesi, Türkiye
Rasim Güzel
Türkiye
Kemal Sarıca
Gebze Teknik Üniversitesi, Türkiye
Özet
The purpose of this article is to identify the factors that predict the success of retrograde intrarenal surgery (RIRS), with a focus on the effect of renal parenchymal thickness and anticoagulant use on stone-free rates. From February 2014 to April 2022, cases of kidney stones treated with RIRS at our clinic were retrospectively screened. The study included 642 cases meeting all inclusion and exclusion criteria. The patients who were observed to be stone free after a single session of RIRS were assigned to Group F, while those with residual fragments were assigned to Group R. Group F comprised 472 patients, while Group R included 170 patients. The two groups have compared certain preoperative and postoperative laboratory and radiological parameters. The infundibulopelvic angle was significantly more acute in Group R (45.63 ± 16.25 vs. 49.28 ± 15.36, p = 0.011) while patients in Group F tended to have thicker parenchyma (27.39 ± 8.38 vs. 22.88 ± 5.56, p < 0.001). In our analysis of multivariate logistic regression, stone size (OR: 1.074, 1.037–1.113; p < 0.001), lower calyceal location (OR: 0.550, 95% CI 0.364–0.831; p = 0.005), multiple numbers of stones (OR 0.254, 95% CI 0.166–0.389; p = < 0.001), the value of parenchymal thickness (OR 0.911, 95% CI 0.882–0.941; p = < 0.001) and more importantly use of anticoagulants/antiplatelets (OR 0.557, 95% CI 0.333–0.933; p = 0.026) appeared to be independent predictors of stone-free status after RIRS. Further evaluation of the data revealed that the cut-off value of the renal parenchymal thickness for an effective stone-free status in a ROC curve analysis was 24.5 with 62.9% sensitivity and 56.8% specificity (area under curve value: 0.654 [95% CI 0.608–0.699, p < 0.001]). The endourologist may be able to make more informed decisions by evaluating renal parenchymal thickness in addition to patient-related factors like anticoagulant use, which we find significantly affects outcomes, along with the stone and renal anatomy-related factors.
Anahtar Kelimeler
Kidney stones | Retrograde intrarenal surgery | Anticoagulants | Parenchymal thickness
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı UROLITHIASIS
Dergi ISSN 2194-7228
Dergi Tarandığı Indeksler SCI-Expanded
Dergi Grubu Q2
Makale Dili Türkçe
Basım Tarihi 01-2023
Cilt No 51
Sayı 1
Sayfalar 30 / 0
Doi Numarası 10.1007/s00240-022-01404-4
Makale Linki https://doi.org/10.1007/s00240-022-01404-4