TY - JOUR
T1 - The Clinical Efficacy of Dual-Lumen Catheter Technique in Retrograde Intrarenal Surgery for the Management of Nephrolithiasis
T2 - A Propensity Score Analysis
AU - Kim, Hyung Suk
AU - Yoo, Sangjun
AU - Cho, Sung Yong
N1 - Publisher Copyright:
© Copyright 2018, Mary Ann Liebert, Inc.
PY - 2018/12
Y1 - 2018/12
N2 - Objective: To assess the clinical efficacy of dual-lumen catheter technique in retrograde intrarenal surgery (RIRS) in terms of stone-free rate. Methods: The data of 172 patients who underwent RIRS for renal stones between 2010 and 2017 were retrospectively reviewed. Patients were classified into two groups depending on whether the dual-lumen catheter technique was used (group 1, n = 25) or not (group 2, n = 147) during RIRS. In turn, all patients of group 1 were compared with those of group 2 using propensity score analysis methods. Clinical variables, including post-RIRS residual fragments (RFs) (≥2 mm) and dusts (sandy stones) (≤1 mm), were compared between both groups. Logistic regression analyses were conducted to identify the predictors of postoperative RFs and dusts. Results: According to propensity score analysis, no other clinical variables were significantly different between the two groups, except the dust-free rate was significantly higher in group 1 than in group 2 (92% vs 40%, p < 0.001). In multivariate analysis, the performance of dual-lumen catheter technique was an independent predictor of the absence of dusts after RIRS (odds ratio [OR], 0.040; 95% confidence interval [CI], 0.070-0.220). In addition, on performing multivariate analyses in another matched population, it was found that although the technique adversely affected the removal of RFs (OR, 4.711; 95% CI, 1.203-18.447), it showed an excellent effect on the evacuation of dusts (OR, 0.049; 95% CI, 0.007-0.347). Conclusion: Our analyses suggest that the use of dual-lumen catheter during RIRS can facilitate the evacuation of sandy stones. However, further prospective randomized trials are required to verify the usefulness of this technique in real clinical practice.
AB - Objective: To assess the clinical efficacy of dual-lumen catheter technique in retrograde intrarenal surgery (RIRS) in terms of stone-free rate. Methods: The data of 172 patients who underwent RIRS for renal stones between 2010 and 2017 were retrospectively reviewed. Patients were classified into two groups depending on whether the dual-lumen catheter technique was used (group 1, n = 25) or not (group 2, n = 147) during RIRS. In turn, all patients of group 1 were compared with those of group 2 using propensity score analysis methods. Clinical variables, including post-RIRS residual fragments (RFs) (≥2 mm) and dusts (sandy stones) (≤1 mm), were compared between both groups. Logistic regression analyses were conducted to identify the predictors of postoperative RFs and dusts. Results: According to propensity score analysis, no other clinical variables were significantly different between the two groups, except the dust-free rate was significantly higher in group 1 than in group 2 (92% vs 40%, p < 0.001). In multivariate analysis, the performance of dual-lumen catheter technique was an independent predictor of the absence of dusts after RIRS (odds ratio [OR], 0.040; 95% confidence interval [CI], 0.070-0.220). In addition, on performing multivariate analyses in another matched population, it was found that although the technique adversely affected the removal of RFs (OR, 4.711; 95% CI, 1.203-18.447), it showed an excellent effect on the evacuation of dusts (OR, 0.049; 95% CI, 0.007-0.347). Conclusion: Our analyses suggest that the use of dual-lumen catheter during RIRS can facilitate the evacuation of sandy stones. However, further prospective randomized trials are required to verify the usefulness of this technique in real clinical practice.
KW - Laser
KW - Lithotripsy
KW - Nephrolithiasis
KW - Ureteroscopy
KW - Urinary catheters
UR - http://www.scopus.com/inward/record.url?scp=85060009187&partnerID=8YFLogxK
U2 - 10.1089/end.2017.0742
DO - 10.1089/end.2017.0742
M3 - Article
C2 - 29316803
AN - SCOPUS:85060009187
SN - 0892-7790
VL - 32
SP - 1093
EP - 1099
JO - Journal of Endourology
JF - Journal of Endourology
IS - 12
ER -