Fortis Superspeciality Hospital, India
: J Kidney
Objective: Retrograde intra-renal surgery (RIRS) is considered as a minimally invasive procedure for management of renal stones with minimal morbidity. Our objective is to demonstrate its effectiveness in management of large, multiple and staghorn stones in our institution. Methods: A prospective study was done of 274 patients who presented to us with renal and upper ureteric stones and were managed with RIRS. Pre-operatively, stone size and laterality were assessed on NCCT KUB and X-ray KUB. Intra-operative parameters were assessed such as; operative time, need for ureteric dilatation and intra-operative complications. Post operatively, X-ray KUB/USG KUB was done before stent removal. Results: Out of 274 patients, 185 patients were male and 89 were female. 83 patients had single stone and 191 patients had multiple stones. 25 patients were pre stented in view of septicemia or renal impairment. 47 patients had renal impairment at the time of presentation, which improved in all patients and returned to normal value in 36 patients. 85 patients underwent bilateral RIRS and 189 underwent unilateral RIRS. 175 patients had more than 2 cm sized stones. Six patients had residual stones out of which, three patients underwent URS, two patients underwent RIRS and one patient underwent ESWL. Conclusion: RIRS is feasible in case of large stone burden, like partial and complete staghorn stones along with multiple stones. Our study demonstrates its effectiveness in large stone burden with additional procedure required in < 3% patients.
Rajinder Yadav had completed his MCh in Urology from AIIMS in 1980. He joined as Sr. Lecturer at PGI Medical College, Rohtak. He had established and developed many departments of Urology and MIS in various hospitals in Delhi. He was Chairman of Urology & Renal Transplant in BLK and Max Hospital. He is the Director of Urology & Kidney Transplant at Fortis Healthcare, a premier healthcare organization. He had performed more than 30,000 surgeries including endoscopic, laparoscopic/retroperitoneoscopic surgeries, kidney transplants, more than 1,000 RIRS and around 1,500 laser prostatectomies (Holmium, KTP, Thulium & Diode).