Journal of Universal Surgery

  • ISSN: 2254-6758
  • Journal h-index: 6
  • Journal CiteScore: 0.94
  • Journal Impact Factor: 0.82
  • Average acceptance to publication time (5-7 days)
  • Average article processing time (30-45 days) Less than 5 volumes 30 days
    8 - 9 volumes 40 days
    10 and more volumes 45 days
Awards Nomination 20+ Million Readerbase
Indexed In
  • Genamics JournalSeek
  • Directory of Research Journal Indexing (DRJI)
  • OCLC- WorldCat
  • Euro Pub
  • Google Scholar
  • J-Gate
  • International Committee of Medical Journal Editors (ICMJE)
  • Zenodo
Share This Page

Review Article - (2023) Volume 11, Issue 2

Retrograde Intrarenal Surgery in Patients Experienced Open Renal Stone Surgery

Alkan Erdal*
Department of Urology, Memorial Sisli Hospital, Okmeydani, Sisli, Istanbul, Turkey
*Correspondence: Alkan Erdal, Department of Urology, Memorial Sisli Hospital, Okmeydani, Sisli, Istanbul, Turkey, Email:

Received: 01-Feb-2023, Manuscript No. IPJUS-23-13487; Editor assigned: 02-Feb-2023, Pre QC No. IPJUS-23-13487 (PQ); Reviewed: 15-Feb-2023, QC No. IPJUS-23-13487; Revised: 21-Feb-2023, Manuscript No. IPJUS-23-134847 (R); Published: 28-Feb-2023, DOI: 10.36648/2254- 6758.


Reason: To discover whether Retrograde Intra Renal Surgery (RIRS) is as successful in patients treated already with Open Renal Stone Surgery (ORSS) on the same kidney as in patients with no past ORSS.

Strategies: There were 32 patients with renal stones who had past ORSS and were treated with RIRS within the consider gather (Gather 1). A add up to of 38 patients with renal stones who had no past ORSS and were treated with RIRS were chosen as the control bunch (Bunch 2). Recorded information with respect to preoperative characteristics of the patients, stone properties, surgical parameters, results, SFRs (no parts or little parts < 4 mm), and complications between bunches were compared. Comes about Cruel age, cruel BMI, cruel healing center remain, and cruel agent time were not factually diverse between bunches. Cruel stone measure (10.1 ± 5.6 versus 10.3 ± 4.2) and cruel stone burden (25.4 ± 14.7 versus 23.5 ± 9.9) were moreover comparative between bunches. After the moment strategies, SFRs were 100% and 95.


Renal; Cardiac; Surgery; Patients; Spine


The surgical strategies within the treatment of stone disease have significantly changed within the final 20 years. There has been a noteworthy diminish within the number of patients requiring Open Renal Stone Surgery (ORSS) due to the innovative improvements within the field of urologic surgery. These Days Shock Wave Lithotripsy (SWL) and Percutaneous Nephro Lithotomy (PNL) are prescribed as the primary line treatment modalities within the administration of renal stones < 20 mm and > 20 mm, separately. Be that as it may, ORSS has been performed in 0.47-2% in select patients. Since stone repeat rate inside 5 a long time is approximately 50%, different mediations may be required for patients with stone malady. Reoperation in patients with past Open Renal Stone Surgery (ORSS) would be troublesome due to retroperitoneal scarring around the kidney and twisting of the pelvic aliceal life systems. Inevitably, reoperation may be related with a longer agent time, higher complication, and lower victory rates [1, 2].

This think about was planned as a review controlled ponder and included patients who experienced RIRS between December 2007 and January 2015. There were 32 patients with renal stones who had past ORSS and treated with RIRS within the ponder bunch (Bunch 1). A add up to of 38 patients with renal stones who had no past ORSS and treated with RIRS were chosen as the control bunch (Bunch 2). To begin with 4-5 patients from each year (2008-2015) who were treated with RIRS but did not experience ORSS were picked out and put together to create the control gather. Patients with renal stones along with ureteral stones were also included in this consider. All patients were preoperatively assessed by CT filter with stone convention to characterize the overall stone burden and collecting framework life structures. Stone burden was calculated by measuring the most extreme stone measurement in cases with single stone or whole of measurements in cases of numerous stones. Recorded information with respect to preoperative characteristics of the patients was included [3-5].


All methods were exhausted a standard lithotomy position beneath common anesthesia. In patients with intrarenal stones and concomitant center or lower ureteral stones, a semirigid ureteroscope (8/9.8F Olympus, Tokyo, Japan) was utilized to begin with for the treatment of ureteral stones. RIRS was performed by three experienced specialists (each specialist performed at slightest 100 RIRS methods) utilizing URF P-5 adaptable ureteroscope (Olympus, Tokyo, Japan) or Cobra adaptable dual-channel ureteroscope (Richard Wolf, Knittlingen, Germany) concurring to its accessibility. A ureteral get to sheath (Flexor ureteral get to sheath 12/14F 35 cm; Cook Therapeutic, Bloomington, IN, USA) was utilized routinely in arrange to get to to the collecting framework effectively and diminish the intrarenal weight. In cases where the ureteral get to sheath or adaptable ureteroscope without get to sheath seem not be progressed due to ureteral pathologies such as ureteral stricture, a ureteral stent was embedded into the ureter and the method [6].

All investigations were performed utilizing SPSS adaptation 16.0 (Measurable Bundle for Social Sciences for windows; Chicago, IL, USA). The estimation information was communicated as cruel ± standard determination. Age, BMI, stone number, stone measure, stone burden, agent times, and hospitalization times were compared by utilizing Mann-Whitney test. Also, utilize of ureteral get to sheath and bushel catheter, inside stent arrangement, SFR, and complication rates were compared by utilizing Pearson Chi- Square test. Esteem of < 0.05 was considered measurably significant in all the cases [7].


A add up to of 41 RIRS strategies performed on 32 patients were included in gather 1. Whereas 27 of 32 (85%) patients required a single strategy, 3 (9%) patients were treated with 2 methods. Two (6%) more patients with two-sided renal stones required add up to of 8 methods (two methods for each kidney) in gather of all. On the other hand, RIRS was performed in 34 of 38 (90%) patients as a single method in bunch. Moreover second-session RIRS was performed in 2 (5%) patients, and respective RIRS was exhausted another 2 (5%) patients. As a result, add up to of 41 and 42 RIRS strategies performed on 32 and 38 patients were included in bunches 1 and 2, separately. RIRS were performed due to back torment (54%), renal colic (23%), repetitive urinary tract contaminations (11%), tireless hematuria (9%), and persistent preference (3%). Lower ureteral stones in conjunction with renal stones were display in 3 and 5 patients in bunches 1 and 2, separately. These stones were treated at the same session [8].

No major perioperative complications were seen. A few minor complications were recorded in 7 patients in each gather. Minor ureteral injury happened in 1 and 2 patients in bunches 1 and 2, individually. Intraoperative hemorrhage was seen in 1 case in each bunch. The methods were not cancelled due to intraoperative complications and the operations were completed without any trouble. Renal colic was recognized in 3 and 2 patients in bunches 1 and 2. Four patients with renal colic were treated with parenteral medicines within the crisis setting in bunches 1 and 2 (Clavien 2). On the other hand, inner stent was put in one persistent with renal colic in bunch 2 due to hydroureteronephrosis (Clavien 3b). Drawn out hematuria that endured longer than a week was seen in one persistent in each bunch and treated conservatively without any transfusion (Clavien 1). Urinary Tract Disease (UTI) was seen in one quiet in each gather. The quiet with pyelonephritis was treated with parentery conditions [9, 10].



Conflict of Interest



  1. Wilkoff BL, Cook JR, Epstein AE, Greene HL, Hallstrom AP, et al. (2002) Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial. JAMA 288: 3115-23.
  2. Indexed at, Google Scholar, Crossref

  3. Pena Rafael E, Shepard Richard K, Ellenbogen Kenneth A (2006) How to make a submuscular pocket. J Cardiovasc Electrophysiol 17: 1381-1383.
  4. Indexed at, Google Scholar, Crossref

  5. Marco D, Eisinger G, Hayes DL (1992) Testing of work environments for electromagnetic interference. Pacing Clin Electrophysiol 15: 2016-22.
  6. Indexed at, Google Scholar, Crossref

  7. Ferreira António M, Costa Francisco, Marques Hugo, Cardim Nuno, Adragão Pedro, et al. (2014) MRI-conditional pacemakers: current perspectives. Med Devices: Evid Res 7: 115-124.
  8. Indexed at, Google Scholar, Crossref

  9. Dean Meara, Ramsay Robert, Heriot Alexander, Mackay John, Hiscock Richard Lynch, et al.  (2017) Warmed, humidified CO2 insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta-analysis. Asian J Endosc Surg 10: 128-136.
  10. Indexed at, Google Scholar, Crossref

  11. Ma Y, Yang Z, Qin H, Wang Y (2011) A meta-analysis of laparoscopy compared with open colorectal resection for colorectal cancer. Medical Oncology 28: 925-933.
  12. Indexed at, Google Scholar,  Crossref

  13. Semm K (1983) Endoscopic appendectomy. Endoscopy 15: 59-64.
  14. Indexed at, Google Scholar,  Crossref

  15. Katz Aviva L, Webb Sally A, Macauley, Robert C, Mercurio Mark R, et al. (2016) Informed Consent in Decision-Making in Pediatric Practice. Pediatrics 138: 14-85.
  16. Indexed at, Google Scholar, Crossref

  17. Mazur Kate A, Berg Stacey L (2020) Ethical Issues in Pediatric Hematology. Oncology 13-21.
  18. Indexed at, Google Scholar, Crossref

  19. Stern, Alexandra Minna, Markel Howard (2002) Formative Years: Children's Health in the United States, 1880-2000. UMHS 23-24.
  20. Indexed at, Google Scholar, Crossref