دورية أكاديمية
Size is Not Everything That Matters: Preoperative CT Predictors of Stone Free After RIRS.
العنوان: | Size is Not Everything That Matters: Preoperative CT Predictors of Stone Free After RIRS. |
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المؤلفون: | Danilovic A; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. Electronic address: alexandre.danilovic@hc.fm.usp.br., Rocha BA; Department of Radiology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Torricelli FCM; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Marchini GS; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Batagello C; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Vicentini FC; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Traxer O; Sorbonne Université, GRC n 20 Lithiase Renale, AP-HP, Hôpital Tenon, Paris, France., Viana PCC; Department of Radiology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Srougi M; Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Nahas WC; Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil., Mazzucchi E; Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. |
المصدر: | Urology [Urology] 2019 Oct; Vol. 132, pp. 63-68. Date of Electronic Publication: 2019 Jul 13. |
نوع المنشور: | Journal Article; Observational Study |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE |
أسماء مطبوعة: | Publication: New York : Elsevier Science Original Publication: Ridgewood, N.J., Professional Medical Services Co. |
مواضيع طبية MeSH: | Tomography, X-Ray Computed*, Kidney/*surgery , Kidney Calculi/*pathology , Kidney Calculi/*surgery , Urologic Surgical Procedures/*methods, Adolescent ; Adult ; Aged ; Female ; Humans ; Kidney Calculi/diagnostic imaging ; Male ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Prospective Studies ; Remission Induction ; Treatment Outcome ; Young Adult |
مستخلص: | Objective: To define computed tomography (CT) predictors of residual fragments after retrograde intrarenal surgery (RIRS) for kidney stones up to 20 mm in patients never submitted to surgical procedures for stone removal. Methods: From August 2016 to August 2017, symptomatic adult patients with kidney stones less than 20 mm treated by RIRS had their pre- and postoperative CT prospectively evaluated in search for predictors of residual stone fragments. Stone size, stone volume, number of stones, stone density, and location were evaluated in preoperative CT and analyzed as predictors for residual stone fragments on 90 POD CT. Stone location was represented by the infundibulopelvic angle (IPA) measured for each stone on preoperative noncontrast CT using multiplanar reconstruction. Results: Ninety-two patients were successfully submitted to RIRS. Bilateral procedures were performed in 23 patients (25%) resulting in 115 renal units operated. Operative time was 54.5 ± 26.7 minutes (mean ± SD) and 96.7% (89/92) of the patients were discharged up to 12 hours after the procedure. Postoperative CT demonstrated stone-free in 86 of 115 (74.8%), 0-2 mm in 10 of 115 (8.7%), and > 2 mm residual fragments in 19 of 115 (16.5%) procedures. Logistic regression analysis revealed steep IPA was a predictor for any residual stone fragment after RIRS for kidney stones < 20 mm (P= .012). ROC curve showed that IPA < 41° was associated with a higher chance of residual fragments after RIRS. Conclusion: IPA < 41° is associated with a higher chance of residual fragments after RIRS for kidney stones up to 20 mm. (Copyright © 2019 Elsevier Inc. All rights reserved.) |
تواريخ الأحداث: | Date Created: 20190717 Date Completed: 20200115 Latest Revision: 20200115 |
رمز التحديث: | 20231215 |
DOI: | 10.1016/j.urology.2019.07.006 |
PMID: | 31310774 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1527-9995 |
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DOI: | 10.1016/j.urology.2019.07.006 |