To conduct a systematic review (SR) of literature to assess the existing evidence concerning the success and complications of endourological ex vivo stone surgeries.
Eligible studies for inclusion focused on investigating the success and complications related to endourological ex vivo surgeries in donors with nephrolithiasis. A SR was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search included databases of Web of Science, PubMed and Scopus and only article in English were included. Studies published between 2002 and 2023 included in this SR.
After screening 1726 abstracts, this SR included 16 studies with a total of 209 patients. The mean stone size was 5.6mm and majority of kidneys contained single stones, located in the lower calyx. After ex vivo endourological stone surgeries, the average stone-free rate was found to be 95.4%. The mean duration of ex vivo surgery was 17.3 minutes. Regarding intraoperative complications, two patients (1%) experienced mucosal injuries during pneumatic lithotripsy. As for postoperative complications, two patients (1%) experienced vascular complications. In terms of urological complications, hematuria was observed in 24 patients (11.5%), while one patient (0.5%) experienced clot formation in renal pelvis. Seven patients (3.3%) had urinary tract infections, and three patients (1.4%) developed urolithiasis during the follow-up. Additionally, one patient (0.5%) experienced complete occlusion of ureteroneocystostomy and required revision.
Given the advancements in current technology and techniques, endourological ex vivo stone surgeries are increasingly recognized as an effective and safe option for donors with nephrolithiasis.
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Urology. 2024 Jun 13 [Epub ahead of print]
Hakan Bahadir Haberal, Senol Tonyali, Alberto Piana, Etienne Xavier Keller, Alba Sierra, Beatriz Bañuelos Marco, Lazaros Tzelves, Alessio Pecoraro, Francesco Esperto, Alicia López-Abad, Thomas Prudhomme, Riccardo Campi, Romain Boissier, Amelia Pietropaolo, Alberto Breda, Angelo Territo, EAU Young Academic Urologists (YAU) Kidney Transplantation and Endourology & Urolithiasis Working Groups
Department of Urology, Ankara Ataturk Sanatoryum Training and Research Hospital, Ministry of Health, University of Health Sciences, Ankara, Turkey. Electronic address: ., Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey., Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy., Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain., Department of Urology, Renal Transplant Division, Hospital Clínico Universitario San Carlos, Madrid, Spain., Institute of Urology, University College Hospital London, London, United Kingdom., Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy., Department of Urology, Campus Biomedico University of Rome, Rome, Italy., Department of Urology, Virgen de la Arrixaca University Hospital, Murcia, Spain., Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France., Department of Urology & Renal Transplantation, La Conception University Hospital, Assistance-Publique, Marseille, France., Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Uro-oncology and Kidney Transplant Unit, Department of Urology at "Fundació Puigvert" Hospital, Autonoma University of Barcelona, Spain.