The First 100 Cases of Endoscopic Combined Intrarenal Surgery in Korea: Matched Cohort Analyses versus Shock-Wave Lithotripsy
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: This study presents our initial experience with endoscopic combined intrarenal surgery (ECIRS) for large renal stonesand compares the results of a propensity score-matched cohort of patients undergoing shock-wave lithotripsy (SWL). Materials and Methods: A total of 100 adults underwent ECIRS for renal stones between August 2017 and January 2019. For comparison,2172 patients who underwent a first session of SWL between January 2005 and May 2018 were included in the SWL cohort. Propensity score matching was performed using maximal stone length (MSL), mean stone density (MSD), and stone heterogeneityindex (SHI) scores. Stone-free rate (SFR) and success rate were compared between ECIRS and SWL. Results: In the ECIRS group, the mean MSL, mean MSD, and mean SHI were 28.7±15.2 mm, 1013.9±360.0 Hounsfield units (HU),209.4±104.0 HU, respectively. The SFR was 70%, and the success rate was 82.0% in this group. Although the ECIRS group had larger,harder, and more homogeneous stones than the SWL group, ECIRS showed a higher SFR and success rate than SWL. After propensity-score matching, SFR and success rate remained higher with ECIRS than with SWL (both, p<0.001). In multivariate logistic regression,smaller stone size [odds ratio (OR): 0.947, 95% confidence interval (CI): 0.913–0.979, p=0.002] and lower Seoul NationalUniversity Renal Stone Complexity score (OR: 0.759, 95% CI: 0.610–0.935, p=0.011) were independent predictors of successful ECIRS. Conclusion: ECIRS showed a higher SFR and success rate than SWL for large renal stones. Smaller stone size and lower complexityof stones were associated with a higher likelihood of successful ECIRS.
Abstract
Purpose: This study presents our initial experience with endoscopic combined intrarenal surgery (ECIRS) for large renal stonesand compares the results of a propensity score-matched cohort of patients undergoing shock-wave lithotripsy (SWL). Materials and Methods: A total of 100 adults underwent ECIRS for renal stones between August 2017 and January 2019. For comparison,2172 patients who underwent a first session of SWL between January 2005 and May 2018 were included in the SWL cohort. Propensity score matching was performed using maximal stone length (MSL), mean stone density (MSD), and stone heterogeneityindex (SHI) scores. Stone-free rate (SFR) and success rate were compared between ECIRS and SWL. Results: In the ECIRS group, the mean MSL, mean MSD, and mean SHI were 28.7±15.2 mm, 1013.9±360.0 Hounsfield units (HU),209.4±104.0 HU, respectively. The SFR was 70%, and the success rate was 82.0% in this group. Although the ECIRS group had larger,harder, and more homogeneous stones than the SWL group, ECIRS showed a higher SFR and success rate than SWL. After propensity-score matching, SFR and success rate remained higher with ECIRS than with SWL (both, p<0.001). In multivariate logistic regression,smaller stone size [odds ratio (OR): 0.947, 95% confidence interval (CI): 0.913–0.979, p=0.002] and lower Seoul NationalUniversity Renal Stone Complexity score (OR: 0.759, 95% CI: 0.610–0.935, p=0.011) were independent predictors of successful ECIRS. Conclusion: ECIRS showed a higher SFR and success rate than SWL for large renal stones. Smaller stone size and lower complexityof stones were associated with a higher likelihood of successful ECIRS.
참고문헌 (27)
- Patel SR, "The modern history and evolution of percutaneous nephrolithotomy", J Endourol, 29, pp.153~157 (2015)
- Fernström I, "Percutaneous pyelolithotomy. A new extraction technique", Scand J Urol Nephrol, 10, pp.257~259 (1976)
- Valdivia Uría JG, "Percutaneous nephrolithectomy: simplified technic (preliminary report)", Arch Esp Urol, 40, pp.177~180 (1987)
- Ibarluzea G, "Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access", BJU Int, 100, pp.233~236 (2007)
- Ibarluzea JG, "Supine percutaneous nephrolithotomy and ECIRS", pp.15~23 (2014), Springer
- Scoffone CM, "Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position : a new standard for percutaneous nephrolithotomy?", Eur Urol, 54, pp.1393~1403 (2008)
- Hamamoto S, "Endoscopic combined intrarenal surgery for large calculi : simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy", J Endourol, 28, pp.28~33 (2014)
- Ping H, "Endoscopic combined intrarenal surgery for the treatment of postpercutaneous nephrolithotomy residual stones", Chin Med J(Engl), 129, pp.2885~2887 (2016)
- 정해도, "Real-time simultaneous endoscopic combined intrarenal surgery with intermediate-supine position: Washout mechanism and transport technique", Investigative and Clinical Urology, 59(5), pp.348~354 (2018), 대한비뇨의학회[DOI]
- Kwon O, "Feasibility of single-session endoscopic combined intrarenal surgery for ipsilateral large renal stones and retrograde intrarenal surgery for contralateral renal stones : initial experience", Int J Urol, 24, pp.377~382 (2017)
- 정재용, "Digital Videoscopic Retrograde Intrarenal Surgeries for Renal Stones: Time-to-Maximal Stone Length Ratio Analysis", Yonsei Medical Journal, 59(2), pp.303~309 (2018), 연세대학교의과대학[DOI]
- 정두용, "Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience", 전남의대학술지, 50(2), pp.52~57 (2014), 의과학연구소[DOI]
- Chung DY, "Impact of colic pain as a significant factor for predicting the stone free rate of one-session shock wave lithotripsy for treating ureter stones : a Bayesian logistic regression model analysis", PLoS One, 10, pp.e0123800~ (2015)
- Lee JY, "Stone heterogeneity index as the standard deviation of Hounsfield units : a novel predictor for shock-wave lithotripsy outcomes in ureter calculi", Sci Rep, 6, pp.23988~ (2016)
- Jeong CW, "Seoul National University Renal Stone Complexity Score for predicting stone-free rate after percutaneous nephrolithotomy", PLoS One, 8, pp.e65888~ (2013)
- Jung JW, "Modified Seoul National University renal stone complexity score for retrograde intrarenal surgery", Urolithiasis, 42, pp.335~340 (2014)
- Seitz C, "Rapid extracorporeal shock wave lithotripsy for proximal ureteral calculi in colic versus noncolic patients", Eur Urol, 52, pp.1223~1227 (2007)
- Austin PC, "A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003", Stat Med, 27, pp.2037~2049 (2008)
- Rubin DB, "Matching using estimated propensity scores : relating theory to practice", Biometrics, 52, pp.249~264 (1996)
- Cracco CM, "ECIRS(Endoscopic Combined Intrarenal Surgery)in the Galdakao-modified supine Valdivia position : a new life for percutaneous surgery?", World J Urol, 29, pp.821~827 (2011)
- Wen J, "Minimally invasive percutaneous nephrolithotomy versus endoscopic combined intrarenal surgery with flexible ureteroscope for partial staghorn calculi : a randomised controlled trial", Int J Surg, 28, pp.22~27 (2016)
- Zhao F, "A comparative study of endoscopic combined intrarenal surgery(ECIRS)in the galdakao-modified supine valdivia(GMSV)position and minimally invasive percutaneous nephrolithotomy for complex nephrolithiasis : a retrospective single-center study", Urolithiasis, 49, pp.161~166 (2021)
- Scoffone CM, "Invited review : the tale of ECIRS(Endoscopic Combined IntraRenal Surgery)in the Galdakao-modified supine Valdivia position", Urolithiasis, 46, pp.115~123 (2018)
- Türk C, "EAU guidelines on interventional treatment for urolithiasis", Eur Urol, 69, pp.475~482 (2016)
- Taguchi K, "The Urological Association of Asia clinical guideline for urinary stone disease", Int J Urol, 26, pp.688~709 (2019)
- 양소영, "Does Early Retrograde Intrarenal Surgery Improve the Cost-Effectiveness of Renal Stone Management?", Yonsei Medical Journal, 61(6), pp.515~523 (2020), 연세대학교의과대학[DOI]
- 장기돈, "Impact of Pretreatment Hydronephrosis on the Success Rate of Shock Wave Lithotripsy in Patients with Ureteral Stone", Yonsei Medical Journal, 58(5), pp.1000~1005 (2017), 연세대학교의과대학[DOI]