Mp04-07 Optimizing Outcome Reporting After Robotic Flexible Ureteroscopy for Management of Renal Calculi: Introducing the Concept of Tetrafecta

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) I (MP04)1 May 2024MP04-07 OPTIMIZING OUTCOME REPORTING AFTER ROBOTIC FLEXIBLE URETEROSCOPY FOR MANAGEMENT OF RENAL CALCULI: INTRODUCING THE CONCEPT OF TETRAFECTA Morshed Salah, Mahmoud Laymon, Hossameldin Alnawasra, Mohamed Ibrahim, Tawiz Gul, Bela Tallai, Mohamed Abdelkareem, and Abdulla Al-Ansari Morshed SalahMorshed Salah , Mahmoud LaymonMahmoud Laymon , Hossameldin AlnawasraHossameldin Alnawasra , Mohamed IbrahimMohamed Ibrahim , Tawiz GulTawiz Gul , Bela TallaiBela Tallai , Mohamed AbdelkareemMohamed Abdelkareem , and Abdulla Al-AnsariAbdulla Al-Ansari View All Author Informationhttps://doi.org/10.1097/01.JU.0001008708.00982.a9.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic FURS (RFURS) has shown encouraging results in terms of stone free rate (SFR) and better ergonomics compared to conventional FURS. The goal of this study was to report our initial results of RFURS, furthermore we proposed a novel metrics for composite outcome reporting named tetrafecta. METHODS: A retrospective analysis of electronic records of 100 patients treated with RFURS for renal stones between 2019 till 2023 was performed.Stone characteristics including: number, localization, size and volume were analyzed using the CT scan. Patients with uneventful postoperative course were discharged once full recovery was achieved. All patients were followed up 1-2 months after surgery with CT scan. Tetrafecta was defined as, complete stone removal after a single session,absence of high-grade complications (GIII-V) and same day hospital discharge. RESULTS: Mean patient age and stone size were 40.7±9.2 and 11.7±5.8 mm, respectively. Median stone volume was 916 (421-12235) mm3. Saghorn stones were seen in 12 patients. Preoperative DJ stent was fixed in 58 patients. The median operative time and stone treatment efficiency (STE) were 116 minutes (97-148) and 21.6 mm3/min (8.9-41.6), respectively. A strong positive correlation between stone volume and STE (R=0.8, p<0.0001). The median length of hospital stay was 9.3 hours (5.4-166).Patients' characteristics are shown in Table 1. Tetrafecta was achieved in 70 patients. Complete stone removal in a single session, absence of high-grade complication and same day hospital discharge were obtained in 73, 99 and 95 patients, respectively. Univariate analysis showed that the stone size (p=0.008), acute infundibulopelvic angle (p=0.023) and preoperative stenting (p=0.017) had significant influence on achieving tetrafecta. Multivariate analysis identified preoperative stenting (OR=0.3, 95% CI 0.1-0.8, p=0.019) was independent predictor of tetrafecta achievement. CONCLUSIONS: A comprehensive reporting methodology for reporting outcomes of RFURS is indicated for patient counselling and comparing different techniques. Tetrafecta was achieved in 70% of cases. Absence of preoperative stent was the only predictor of missing tetrafecta. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e36 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Morshed Salah More articles by this author Mahmoud Laymon More articles by this author Hossameldin Alnawasra More articles by this author Mohamed Ibrahim More articles by this author Tawiz Gul More articles by this author Bela Tallai More articles by this author Mohamed Abdelkareem More articles by this author Abdulla Al-Ansari More articles by this author Expand All Advertisement PDF downloadLoading ...