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Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?

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Abstract

The aim of this study was to present the safety and efficacy of retrograde intrarenal surgery (RIRS) procedures that minimize the intraoperative radiation exposure. The totally endoscopy-guided RIRS technique included the following steps: (a) preoperative assessment of pelvicaliceal system anatomy and stone characteristics, (b) thorough evaluation of the ureters by rigid ureteroscopy, (c) a step-wise approach of introducing the ureteral sheath, (d) gathering stones in the more accessible renal calyx before fragmenting them, and (e) a modified holmium laser technique. The RIRS procedures performed by a single surgeon between October 2012 and October 2013 in consecutive patients with renal stones were retrospectively reviewed. The mean stone size was 1.4 ± 0.4 (range 0.8–2.0) cm. The median operative time was 74.5 min. Fluoroscopy was only used in one patient who had a double collecting system with two ureters. The stone-free status was achieved in 134 (95.7 %) patients one month after surgery. Five (3.6 %) patients had minor complications, including hematuria and fever. No major intraoperative complication was observed. We believe that with appropriate preparation, RIRS without fluoroscopic guidance can be safely and efficiently performed by experienced urologists in selected patients with renal stones.

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Acknowledgments

This study has been supported by Foundation of Shanghai Changhai Hospital “1255” Discipline Construction Projects (CH125520302) and Medical Foundation of Shanghai Science and Technology Committee (11411950102).

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The authors declare that they have no competing interests.

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    Authors and Affiliations

    1. Department of Urology, Changhai Hospital, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, People’s Republic of China

      Yonghan Peng, Bin Xu, Wei Zhang, Ling Li, Min Liu, Xiaofeng Gao & Yinghao Sun

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    1. Yonghan Peng
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    2. Bin Xu
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    3. Wei Zhang
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    4. Ling Li
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    5. Min Liu
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    6. Xiaofeng Gao
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    7. Yinghao Sun
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    Corresponding authors

    Correspondence to Xiaofeng Gao or Yinghao Sun.

    Additional information

    Y. Peng, B. Xu and W. Zhang contributed equally to this work and should be considered as co-first authors.

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    Peng, Y., Xu, B., Zhang, W. et al. Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?. Urolithiasis 43, 265–270 (2015). https://doi.org/10.1007/s00240-015-0760-x

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    • DOI: https://doi.org/10.1007/s00240-015-0760-x

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