METHODS: Prospectively data of 115 adult patients with bilateral kidney stone disease undergoing SSB-RIRS across 14 global centers between July 2023 and March 2024 were analyzed. Patient demographics, stone characteristics and operative outcomes were recorded. A low-dose non contrast CT scan was performed at 30 days to assess the stone-free rate and clinical outcomes.
RESULTS: Overall bilateral zero residual fragment(ZRF) was 42.6%; unilateral ZRF was 75.7%. Only two patients were noted to have residual fragments > 4 mm. 1.7% experienced Traxer-Thomas grade 1 ureteric injury which was managed with a ureteral stent for four weeks. No pelvicalyceal injury occured. Postoperative mean loin pain score was 1.7 ± 1.0. None had sepsis nor required blood transfusion. 4.3% required readmission within 30 days of surgery. Multivariate analysis indicated longer total operation time correlated with lower odds of achieving a 100% bilateral stone-free (ZRF) (OR 0.978, 95%CI = 0.959-0.994, p = 0.013).
CONCLUSION: To our knowledge, this is the first multicenter study demonstrating the use of FANS in SSB-RIRS can achieve bilateral ZRF with low complication and re-intervention rates. However, prolonged surgical time may negatively impact outcomes. The indications of bilateral renal stones management with FURS can be expanded in appropriate chosen patients.
METHODS: Our prospective, multicenter study enrolled 704 adult patients from 21 centers who underwent FURS with FANS between August 2023 and October 2024. IO-SFS was categorized into three groups: (1) 100% SFR (no dust or fragments), (2) only dust remaining, and (3) both dust and fragments remaining. PO-SFS was assessed via 2 mm non-contrast computed tomography (NCCT) at 30 days and categorized into four grades: Grade A (100% stone-free), Grade B (single ≤ 2 mm residual fragment), Grade C (single 2.1-4 mm), and Grade D (multiple or any > 4 mm). Primary outcome was correlation between intraoperative and postoperative 100% SFS. Secondary outcomes included perioperative complications, reintervention rates, and predictors of residual fragments and perioperative complications.
RESULTS: IO-SFS reported 100% SFR in 395 cases. Postoperative NCCT confirmed a significantly higher SFS (Grade A + B) in this group (99%) compared to 95.8% in the dust only group and 61.1% in the dust and fragments group (p