The effect of Trendelenburg position on outcomes of retrograde intrarenal surgery for medium sized renal pelvis stones

Year 2022, Volume: 5 Issue: 5, 1351 - 1354, 25.09.2022

Mehmet Yilmaz Salman , Göksel Bayar , Orhun Sinanoğlu

https://doi.org/10.32322/jhsm.1119226

Cited By: 1

Abstract

Aim: To compare safety and efficiency between Trendelenburg position retrograde intrarenal surgery (tRIRS) and conventional position retrograde intrarenal surgery (cRIRS) in the management of renal pelvis stones 10-20 mm in size.
Material and Method: From September 2018 to September 2019, the patients undergoing RIRS for single renal stones between 10-20 mm were included in the study prospectively. Patients were divided into two groups randomly. First group of patients were positioned completely parallel to the ground (cRIRS), second group were positioned with Trendelenburg (tRIRS). Success was evaluated at end of 3rd months by non-contrast enhanced tomography. Stones that smaller than 4 mm were accepted as clinical insignificant residual fragment. Complications was classified according to Clavien, class 2 or more complications were recorded.
Results: Totally 100 patients were included to final analyze. Patients’ age, gender, stone side and mean stone surface area were similar between groups. Success rate was higher in tRIRS group (90% vs 72% p=0.022). Mean operation time was lower (41.8 vs 58.2 min. p<0.001), and mean session number for each patient was lower in tRIRS group (1.17 vs 1.4 p=0.024). Class 2 or higher complications were occurred in six patients; five was in cRIRS, and one in tRIRS group and rate was similar (p= 0.09).
Conclusions: Inclined Trendelenburg position improves success rate and decrease mean session number and operation time on patients whom performed RIRS for renal pelvis stones. Trendelenburg position has similar complication rate compared to conventional position.

Keywords

Retrograde intrarenal surgery, flexible ureteroscopy, Trendelenburg position, renal pelvis stone

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