Endourological Treatment of Renoureteral Lithiasis in Major Outpatient Surgery Regime

Autores/as

Palabras clave:

urolithiasis, nephrolithiasis, ureterolithiasis, ureteroscopy, ambulatory surgical procedures

Resumen

Introduction: The high prevalence of urinary lithiasis, together with medical advances and the need for efficiency in the consumption of healthcare resources, are driving the performance of procedures in major outpatient surgery without compromising the quality of care.

Objectives: To evaluate the efficacy of endourological procedures in the treatment of renoureteral lithiasis under major outpatient surgery in a series of cases.

Methods: Descriptive, longitudinal and retrospective review of 79 patients undergoing semi-rigid ureterorenoscopy and retrograde intrarenal surgery at the Hospital Universitario de Getafe between June-2018 and March-2020 for the treatment of urolithiasis in major outpatient surgery. A descriptive and multivariate statistical analysis of patient characteristics, urolithiasis, surgery and complications was performed.

Results: The 53.2 % (42/79) had a previous ureteral catheter. The stone-free rate was 81%, with a median number of procedures of 1(1 - 4). The mean stone size was significantly larger in those who were not stone free (11.6 mm) compared to those who were stone free (9.3 mm); (p = 0.04). Predictors of success were smaller stone size (OR = 0.850) and absence of previous catheter (OR = 0.25). Intraoperative complications occurred in 15.2% (12/79), and postoperative in 26.6 % (21/79), 100 % minor according to the Clavien-Dindo classification. Admission was required in 25.3 % (20/79) of patients. Only 5.1 % (4/79) were readmitted. Regarding complications, we found no significant differences in the variables analyzed or in the logistic regression model.

Conclusions: Endourological treatments of lithiasis in major outpatient surgery are safe and effective procedures. Smaller lithiasis size and absence of previous catheter are predictors of freedom from postoperative debris.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

1. Oitchayomi A, Doerfler A, Le Gal S, Chawhan C, Tillou X. Flexible and rigid ureteroscopy in outpatient surgery Endourology and technology. BMC Urol. 2016;16:6. DOI: 10.1186/s12894-016-0124-z

2. Ræder J, Nordentoft J. Dagkirurgi og anestesi. Tidsskr den Nor Laegeforening. 2010;130(7):742–6. DOI: 10.4045/tidsskr.08.0341

3. Richman DC. Ambulatory Surgery: How Much Testing Do We Need? Anesthesiol Clin. 2010;28(2):185–97. DOI: 10.1016/j.anclin.2010.03.001

4. Alcalde ÁAF, Hernández MR, Santos VG, Guerrero CS, Pérez DED, Fúnez FA, et al. Comparación entre nefrolitotomía percutánea y ureteroscopia flexible para el tratamiento de litiasis renales de entre 2 y 3 cm. Actas Urol Esp. 2019;43(3):111–7. DOI: 10.1016/j.acuro.2018.08.002

5. Cuvelier G, Legrand G, le Guilchet T, Branchereau J, Larue S, Murez T, et al. Chirurgie ambulatoire en Urologie Argumentaire. Recommandations AFU/SFAR/AFCA/ANAP. Prog Urol. 2013 [access 04/01/2023];23:1-61. Available from: https://onconormandie.fr/wp-content/uploads/2017/10/Chir-ambulatoire-en-uro-argumentaire-reco-AFU-SFAR-AFCA-ANAP-2013.pdf

6. Skolarikos A, Jung H, Neisius A, Petrik A, Somani B, Tailly T, et al. EAU guidelines on Urolithiasis. 2023 [access 04/01/2023]. Available from: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urolithiasis-2023.pdf

7. Trinchieri A, Curhan G, Karlsen S, Jun Wu K. Epidemiology. In: Segura JW, Conort P, Khoury S, Pak CY, Preminger GM, Tolley D, eds. Stone Disease. Paris: Health Publications; 2003: p.13-30.

8. Arias Vega MR, Pérula de Torres LA, Carrasco Valiente J, Requena Tapia MJ, Jiménez García C, Silva Ayçaguer LC. Prevalence of urolithiasis in the 40 to 65 year old Spanish population: The PreLiRenE study. Med Clín (Barc). 2016;146(12):525–31. DOI: 10.1016/j.medcli.2016.03.013

9. Hyams ES, Shah O. Percutaneous Nephrostolithotomy Versus Flexible Ureteroscopy/Holmium Laser Lithotripsy: Cost and Outcome Analysis. J Urol. 2009;182(3):1012–7. DOI: 10.1016/j.juro.2009.05.021

10. Geavlete P, Georgescu D, Niţă G, Mirciulescu V, Cauni V. Complications of 2735 retrograde semirigid ureteroscopy procedures: a single-center experience. J Endourol. 2006;20:179–85. DOI: 10.1089/end.2006.20.179

11. Martínez-Corral ME, Núñez-Otero JJ, Fernández-Baltar C, Masid-Gómez A, Valiño-Hortas C, Pérez-Fentes D. Initial results of endourological treatment of renoureteral lithiasis by means of flexible ureteroscopy and percutaneous surgery in an outpatient procedure in a tertiary care center. Actas Urol Esp (Engl Ed). 2023;47(1):15-21. DOI: 10.1016/j.acuroe.2022.09.004

12. Chabannes E, Bensalah K, Carpentier X, Bringer JP, Conort P, Denis E, et al. Prise en charge urologique des calculs rénaux et urétéraux de l’adulte. Mise au point du Comité lithiase de l’Association française d’urologie (CLAFU). Aspects généraux. Prog Urol. 2013;23(16):1389–99. DOI: 10.1016/j.purol.2013.08.315

13.Munnich EL, Parente ST. Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up. Health Aff. 2014;34(5):764–9. DOI: 10.1377/hlthaff.2013.1281

14. Gill IS, Hobart MG, Schweizer D, Bravo EL. Outpatient adrenalectomy. 2000;163(March):717–20. DOI: 10.1016/S0022-5347(05)67790-7

15. Moughnyeh M, Lindeman B, Porter JR, Dream S. Outpatient robot-assisted adrenalectomy : Is it safe ? Am J Surg. 2020;4–5. DOI: 10.1016/j.amjsurg.2020.04.037

16. Kim SJ, Koh CJ. Outpatient Robotic Surgery Can Be Done: How Many Near Events? J Urol. 2022;207(4):752–3. DOI: 10.1097/ju.0000000000002435

17. Abaza R, Martinez O, Ferroni MC, Bsatee A, Gerhard RS. Same Day Discharge after Robotic Radical Prostatectomy. J Urol. 2019;202(5):959–63. DOI: 10.1097/ju.0000000000000353

18. Congnard D, Vincendeau S, Lahjaouzi A, Neau AC, Chaize C, Estèbe JP, et al. Outpatient robot-assisted radical prostatectomy: A feasibility study. Urology. 2019;128:16-22. DOI: 10.1016/j.urology.2019.01.050

19. Ragavan N, Dholakia K, Baskaran J RM. Day-case laparoscopic nephrectomy: Feasibility and safety. J Clin Urol. 2019;12((6):466–9. DOI: 10.1177/2051415819852278

20. Mehrazin R, Bortnick E, Rollin S, Winoker J. Ambulatory Robotic-Assisted Partial Nephrectomy: Safety and Feasibility Study. Urology. 2020;143:137-41 DOI: 10.1016/j.urology.2020.04.111

21. Ragavan N, Bafna S, Thangarasu M, Prakash S, Paul R CP. Day-case robot-assisted laparoscopic surgery: Feasibility and safety. Turk J Urol. 2021;47(1):30–4. DOI: 10.5152/tud.2020.20414

22. Yip KH, Lee CW, Tam PC. Holmium laser lithotripsy for ureteral calculi: An outpatient procedure. J Endourol. 1998;12(3):241–6. DOI: 10.1089/end.1998.12.241

23. Taylor AL, Oakley N, Das S, Parys BT. Day-case ureteroscopy: An observational study. BJU Int. 2002;89(3):181-5. DOI: 10.1046/j.1464-4096.2001.01309.x

24. Chen JJ, Yip SK, Wong MY, Cheng CW. Ureteroscopy as an out-patient procedure: The Singapore General Hospital Urology Centre experience. Hong Kong Med J. 2003 [access 04/01/2023];9(3):175–8. Availale from: https://www.hkmj.org/abstracts/v9n3/175.htm

25. Schoenfeld D, Zhou T, Stern JM. Outcomes for Patients Undergoing Ambulatory Percutaneous Nephrolithotomy. J Endourol. 2019;33(3):1–19. DOI: 10.1089/end.2018.0579

26. Wu X, Zhao Z, Sun H, Cai C, Li Z, Cheng D, et al. Day ‑ surgery percutaneous nephrolithotomy: a high ‑ volume center retrospective experience. World J Urol. 2020;38(5):1323-8. DOI: 10.1007/s00345-019-02942-0

27. Chong JT, Dunne M, Magnan B, Abbott J, Dávalos JG. Ambulatory Percutaneous Nephrolithotomy in a Free-Standing Surgery Center: An Analysis of 500 Consecutive Cases. J Endourol. 2021;35(12):1738-42. DOI: 10.1089/end.2021.0159

28. Johnston SS, Johnson BH, Rai P, Grange P, Amos T, Ghosh S, et al. Trends and patterns of initial percutaneous nephrolithotomy and subsequent procedures among commercially ‑ insured US adults with urinary system stone disease: a 10 ‑ year population ‑ based study. World J Urol. 2023;41(1):235–40. DOI: 10.1007/s00345-022-04210-0

Descargas

Publicado

2023-10-24

Cómo citar

1.
García-Cano Fernández AM, Szczesniewski Dudzik JJ, González Montes L, Boronat Catalá J, Rodríguez Castro PM, Llanes gonzález L. Endourological Treatment of Renoureteral Lithiasis in Major Outpatient Surgery Regime. Rev. Cubana Urol. [Internet]. 24 de octubre de 2023 [citado 22 de diciembre de 2024];12(3):e992. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/992

Número

Sección

Endourología y laparoscopia

Artículos más leídos del mismo autor/a