Pd10-07 the Reused-Disposable Flexible Scopes in Retrograde Intra-Renal Surgery for Stones: Preliminary Outcomes From a Multicenter Study of 2183 Patients by the Tower Group

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10)1 May 2024PD10-07 THE REUSED-DISPOSABLE FLEXIBLE SCOPES IN RETROGRADE INTRA-RENAL SURGERY FOR STONES: PRELIMINARY OUTCOMES FROM A MULTICENTER STUDY OF 2183 PATIENTS BY THE TOWER GROUP Mohamed Amine Lakmichi, Olivier Traxer, Ravindra Sabnis, Khi Yung Fong, Parimal Sinh Gharia, Deepak Ragoori, Ee Jean Lim, Yiloren Tanidir, Amish Mehta, Mehmet Ilker Gökcej, Boyke Soebhali, Nariman Gadzhiev, Ben H. Chew, Bhaskar K. Somani, Daniele Castellani, and Vineet Gauhar Mohamed Amine LakmichiMohamed Amine Lakmichi , Olivier TraxerOlivier Traxer , Ravindra SabnisRavindra Sabnis , Khi Yung FongKhi Yung Fong , Parimal Sinh GhariaParimal Sinh Gharia , Deepak RagooriDeepak Ragoori , Ee Jean LimEe Jean Lim , Yiloren TanidirYiloren Tanidir , Amish MehtaAmish Mehta , Mehmet Ilker GökcejMehmet Ilker Gökcej , Boyke SoebhaliBoyke Soebhali , Nariman GadzhievNariman Gadzhiev , Ben H. ChewBen H. Chew , Bhaskar K. SomaniBhaskar K. Somani , Daniele CastellaniDaniele Castellani , and Vineet GauharVineet Gauhar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008748.59024.cb.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cost is an important consideration in planning flexible ureteroscopy (FU). In deed, saving costs for patients who come from economically challenged environments was the main concern for most surgeons. This study aimed to understand the outcomes of FU for renal and proximal ureteric stones in adults with regards to residual fragments (RFs), and their effect on sepsis using what we define as a new category called Reused-Disposable Scopes (RDS). METHODS: Data from adults from 11 centers were retrospectively reviewed (January 2020-December 2022). Inclusion criteria: ureteral/renal stone(s). Residual fragments (RFs): single fragment ≥4 mm or multiple fragments of any size within 3 months. Outcome Measurements and Statistical Analysis Continuous variables are presented as median and (interquartile range). Outcomes: factors affecting RFs and infections at multivariable logistic analysis. RESULTS: 2183 patients were included. 67.0% were male. Median age was 48.0 (36-59) years. Median stone diameter was 10.2(9-14) mm. The prevalent mode of sterilisation was flash technique (90.2%). 88% of patients had RIRS with an RDS used ≤2 times (12%: 3-5 times). RDS needed to be changed in 3.9% of cases. The most common issue that affected RDS function were upward (1.8%) and downward deflection (7.4%) and image quality on white balancing (1.1%). Fever >38C was seen in 13.7% of cases, sepsis in 0.5%. RFs were found in 31.4% of cases. Lower pole stone (OR 5.63) or pelvis (OR 4.67), faulty scope changed (OR 12.8), total operation time (OR 1.05,) were factors associated with higher odds of RFs. Stone size (OR 1.09), positive urine culture (OR 1.67), middle pole stone (OR 1.68), pre-stenting (OR 1.37) were associated with higher odds of fever/sepsis. Limitations: retrospective study, no cost-analysis. CONCLUSIONS: To the best of our knowledge, this is the first study to assess the outcome of FU for kidney and upper ureteral stones performed with RDS. The use of RDS was associated with a low rate of postoperative infectious complications and acceptable RFs rate. The practices reported are not standardized and cannot be recommended as a standard practice without detailed investigations.Finally, RDS is a reality as a cost-cutting strategy with healthcare systems adopting strict regulations and recommendations. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e188 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamed Amine Lakmichi More articles by this author Olivier Traxer More articles by this author Ravindra Sabnis More articles by this author Khi Yung Fong More articles by this author Parimal Sinh Gharia More articles by this author Deepak Ragoori More articles by this author Ee Jean Lim More articles by this author Yiloren Tanidir More articles by this author Amish Mehta More articles by this author Mehmet Ilker Gökcej More articles by this author Boyke Soebhali More articles by this author Nariman Gadzhiev More articles by this author Ben H. Chew More articles by this author Bhaskar K. Somani More articles by this author Daniele Castellani More articles by this author Vineet Gauhar More articles by this author Expand All Advertisement PDF downloadLoading ...