This study aims to review the current role of endoscopic combined intrarenal surgery (ECIRS) in the management of renal stones, with a focus on its efficacy and safety. The secondary outcome was to highlight the tips and tricks to improve the urologist's experience with ECIRS.
A scoping review of the literature, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, was performed, using ECIRS and flexible ureteroscopy and percutaneous nephrolithotomy as the search terms. All original articles were screened and included.
Thirty-three studies were included in the analysis. ECIRS showed a good efficacy and safety profile, with an excellent stone-free rate and a low rate of complications, mostly Clavien-Dindo I/II. With ECIRS, a reduction in the need for multiple access tracts was noted and direct visualization of the targeted calyx during the puncture increased the ability to attain transpapillary punctures, thereby reducing the amount of bleeding.
ECIRS, as the first-line minimal access intervention, is safe and efficacious, particularly for achieving a stone-free status in patients with large complex stones in a single stage. The ability to gain access under direct vision and the reduction in the number of tracts, in both the supine and the prone positions, makes this procedure an attractive surgical choice.
Indian journal of urology : IJU : journal of the Urological Society of India. 2023 Sep 29 [Epub]
Carlotta Nedbal, Victoria Jahrreiss, Clara Cerrato, Daniele Castellani, Wissam Khalid Kamal, Zeeshan Hameed, Vineet Gauhar, Patrick Juliebo-Jones, Lazaros Tzelves, Panagiotis Kallidonis, Theodoros Tokas, Bhaskar K Somani
Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica Delle Marche, Ancona, Italy., Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK., Department of Urology, King Fahad Hospital, Jeddah, Saudi Arabia., Department of Urology, Father Muller Medical College, Mangalore, Karnataka, India., Department of Urology, Ng Teng Fong General Hospital, NUHS, Singapore., Department of Urology, Haukeland University Hospital, Bergen, Norway, Department of Clinical Medicine, University of Bergen, Bergen, Norway, EAU YAU Urolithiasis Group., Department of Urology, Sismanogleio Hospital, National and Kapodistrian University of Athens, Athens, Greece., Department of Urology, University of Patras, Greece., Department of Urology and Andrology, General Hospital Hall I.T., Milser Str. 10, Hall in Tirol, 6060, Austria.