Background
Methods
Design of the study
Outpatient surgery criteria
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Patient consent
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Must be escorted home by a third party and should not be alone the first night following surgery
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Must be able to understand and respect the postoperative surveillance guidelines
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Must not have psychiatric problems preventing collaboration with the Ambulatory Surgery Unit
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Must live in acceptable conditions with access to a phone
Surgical technique
Legislation and statistics
Results
Rigid ureteroscopy | Flexible ureteroscopy | Rigid + flexible ureteroscopy |
p
| ||
---|---|---|---|---|---|
N = 31 | N = 44 | N = 25 | |||
Multiple procedures | 1 | 9 | 3 | 0.05 | |
Gender | F | 8 (26.7 %) | 17 (44.7 %) | 9 (40.9 %) | |
M | 22 (73.3 %) | 18 (55.3 %) | 13 (59.1 %) | ||
Median age at TT (years old) | 54.2 (35.8–66.2) (25.3–82.4) | 43.4 (25.1–60) (21–76.4) | 54.7 (39–61) (26.8–76.4) | 0.07 | |
ASA 1 | 22 | 30 | 10 | ||
ASA 2 | 8 | 5 | 12 | ||
Median BMI (kg/m2) (IQR) (Min-max) | 25.4 (24–28.3) (17.3–37.8) | 26 (24.3–29.3) (18.9–38.1) | 26.8 (23.9–28) (21–39.9) | 1 | |
History of urinary stones treatment (same side) | ESWL | 1 | 4 | 1 | 0.014 |
URS | 2 | 4 | 0 | ||
PCNL | 0 | 3 | 0 | ||
Preoperative JJ stent | 24 (77.4 %) | 35 (79.5 %) | 23 (92 %) | 0.2 | |
Median time between diagnosis and TT (days) (IQR) (min-max) | 58 (30–92.5) (7–146) | 63 (33–80.5) (14–127) | 57.4 (41–80) (14–213) | 0.9 | |
Stones size (mm) (IQR) (min-max) | 7 (6–10) (4–30) | 12.5 (10–17.5) (6–30) | 8 (6.5–14) (4–34) | 0.0008 | |
Median stones density (UH) (IQR) (min-max) | 1000 (900–1200) (550–1330) | 920 (800–1000) (500–1580) | 895 (525–1150) (433–1450) | 0.13 | |
Median operative time (min) (IQR) (min-max) | 41.5 (31–59.5) (10–90) | 60 (52.5–79) (20–150) | 60 (46.2–66.7) (31–90) | <0.0001 | |
Postoperative double pigtail stent | 19 (61.3 %) | 33 (75 %) | 14 (56 %) | 0.2 | |
Stone free | 27/30 (90 %) | 25/35 (71.4 %) | 21/22 (95.4 %) | 0.03 | |
Postoperative complications | Clavien 2 | 0 | 2 APN | 0 | 0.3 |
1 APr | |||||
Clavien 3 | 2 Renal colics | 1 Urinoma | 0 |
Descriptive analysis of operating characteristics
Urinary stone characteristics
Distal ureter stones | Proximal ureter stones | Renal stones |
p
| ||
---|---|---|---|---|---|
N = 16 | N = 22 | N = 62 | |||
Multiple procedures | 0 | 2 | 11 | ||
Rigid ureteroscopy | 14 | 12 | 3 | ||
Flexible ureteroscopy | 0 | 2 | 43 | ||
Both | 2 | 8 | 16 | ||
Gender | Female | 6 | 8 | 24 | |
Male | 10 | 12 | 27 | ||
Median age at TT (years old) (IQR) (Min-max) | 54 (35–54) (25–82) | 52 (23–67) (23–80) | 57 (25–65) (25–76) | 0.8 | |
ASA 1 | 14 | 18 | 34 | ||
ASA 2 | 2 | 2 | 17 | ||
Median BMI (kg/T2) (IQR) (Min-Max) | 25 (24–28) (21–32) | 27 (25–29) (17–40) | 26 (24–28) (19–38) | 0.47 | |
History of urinary stones treatment (same side) | ESWL | 0 | 0 | 6 | 0.035 |
URS | 1 | 0 | 5 | ||
PCNL | 0 | 0 | 3 | ||
Preoperative JJ stent | 14 (87.5 %) | 18 (81.8 %) | 49 (79 %) | 0.74 | |
Median time between diagnosis and TT (days) (IQR) (Min-max) | 86 (50–109) (13–289) | 67 (38–93) (21–151) | 93 (65–156) (25–739) | 0.053 | |
Median Stone size (mm) (IQR) (Min-max) | 7 (5.3–10) (4–30) | 7 (6.3–8) (4–10) | 10 (6.6–13) (2–30) | 0.014 | |
Median stone density (UH) (IQR) (Min-max) | 1003 (930–1125) (550–1310) | 1000 (660–1200) (433–1330) | 943 (618–1000) 500–1580) | 0.24 | |
Median operative time (min) (IQR) (Min-max) | 40 (30–45) (20–60) | 45 (35–60) (10–90) | 60 (50–75) (20–150) | <0.0001 | |
Postoperative double pigtail stent | 8 (50 %) | 15 (68.2 %) | 43 (69.35 %) | 0.33 | |
Stone free after multiple procedures | 15/16 (93.7 %) | 19/20 (95 %) | 38/51 (74.5 %) | 0.053 | |
Postoperative complications | Clavien 2 | 1 AProst | 2 APN | ||
1 Renal colic | 1 Renal colic | ||||
Clavien 3 | 1 Urinoma |