Evaluation of the optimal duration for retrograde intrarenal stone surgery to prevent postoperative complications

Abstract

Objective: To evaluate retrograde intrarenal surgery (RIRS) outcomes and to determine the effect of operative time on complications of RIRS.

Methods: Patients undergoing RIRS for renal stones were evaluated. These patients were divided into two groups according to the operation time (Group 1<60 minutes and Group 2>60 minutes). Peroperative outcomes such as fluoroscopy time, stone-free rates, complications and duration of hospitalization were compared.

Results: Group 1 consisted of 264 patients and Group 2 consisted of 297 patients. SFR rates, duration of hospitalization, and postoperative urinary tract infection rates were similar in both groups. Fluoroscopy time was 7.8±7.3 (0-49) sec in group 1 and 13.1±9.8 (0-81) sec in group 2. Complications according to modified Clavien-Dindo classification system (MCDCS) were 13 and 32 patients (Grade 1), 31 and 63 patients (Grade 2), 1 and 1 patient (Grade 3) in group 1 and 2, respectively. There was statistical difference between the two groups in terms of duration of fluoroscopy time and the MCDCS. Although duration of hospitalization and UTI rates were higher in group 2, no statistical significance was observed among groups.

Conclusion: Limiting the operation time to 60 minutes in RIRS seems to be important in reducing postoperative complications.

Keywords: modified Clavien-Dindo classification system (MCDCS); operation time; renal stone; retrograde intrarenal surgery.