신석의 치료 방법으로서의 Retrograde Intrarenal Surgery (RIRS)의 효용성
The Efficacy of Retrograde Intrarenal Surgery (RIRS) in the Management of Renal Stone Disease
김종원, 박진성, 박형근,
소속 상세정보
김종원 ( Kim Jong-Won )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
박진성 ( Park Jin-Sung )
을지대학교병원 비뇨기과학교실
박형근 ( Park Hyung-Keun )
울산대학교 의과대학 비뇨기과학교실
KMID : 0358320090500080786
Abstract
Purpose: With recent technological advances, the indications for retrograde intrarenal surgery (RIRS) have gradually increased. We evaluated the efficacy and treatment outcomes of RIRS for the treatment of renal stones.
Materials and Methods : We retrospectively reviewed the medical records of 23 patients with renal stones (7 in the renal pelvis, 9 in the renal calyx, and 7 in the renal diverticulum) treated with RIRS from January 2001 to July 2008. Mean stone burden was 110 mm2 (range, 9.42-428.6 mm2), and all operations were performed under general anesthesia using a semi-rigid ureteroscope in 9 cases, a flexible ureteroscope in 11 cases, and both types simultaneously in 3 cases. The holmium:yttrium-aluminum-garnet (Ho: YAG) laser and the nitinol basket were used for stone fragmentation and retrieval. The patients were followed up postoperatively with KUB (21 cases) or nonenhanced computed tomography (CT; 2 cases). Success was defined as no visible stones on KUB or nonenhanced CT.
Results: The mean operating time was 93 minutes (range, 30-205 minutes) and the mean hospital stay was 3.7 days (range, 1-9 days). Of 23 patients, 16 (70%) experienced complete elimination of the stone after only a single intervention. After ancillary extracorporeal shock wave lithotripsy (ESWL), the success rate was increased to 74% (17/23). In the remaining 6 patients, residual stone findings were less than 3 mm and were followed up with X-ray.
Conclusions: RIRS is a feasible procedure for treating renal stone disease with minimal complications. The results of our study suggest that RIRS can be recommended as a primary modality in the management of renal stone disease in selected patients such as those with ESWL failure and renal diverticular stones. (Korean J Urol 2009;50:786-790)
키워드
Ureteroscopes;Lithotripsy
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