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MINERVA UROLOGICA E NEFROLOGICA

A Journal on Nephrology and Urology


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Minerva Urologica e Nefrologica 2018 Mar 28

DOI: 10.23736/S0393-2249.18.02926-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Retrograde intra-renal surgery (RIRS) under spinal anesthesia. The first large series

Andrea BOSIO , Ettore DALMASSO, Eugenio ALESSANDRIA, Simone AGOSTI, Giuseppe PIZZUTO, Dario PERETTI, Anna PALAZZETTI, Alessandro BISCONTI, Paolo DESTEFANIS, Fabrizio FOP, Paolo GONTERO

Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Urology, Turin, Italy


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BACKGROUND: Retrograde intra-renal surgery (RIRS) has become increasingly common and is mainly performed under general anesthesia (GA). There are no specific papers about RIRS performed under spinal anesthesia (SA). Our objective was to evaluate feasibility and results of RIRS performed under spinal anesthesia (SA).
METHODS: We analysed all consecutive RIRS performed for stones in day surgery from March 2008 to September 2012. Single procedures outcomes of RIRS performed under SA were evaluated with US and KUB X-ray at 2 weeks. Further treatments, operative time and complications were also evaluated. Outcomes of RIRS performed under SA and GA were compared. Difference between groups was statistically analysed. Significance level was set at p<0.05.
RESULTS: 139 RIRS under SA and 47 under GA were considered. Mean stone burden was 14 ± 6 mm. No case of conversion from SA to GA occurred. Stone-free rate (SFR) level 4U of RIRS under SA and under GA were respectively 63.6% and 48.6%, SFR level 0U 24.5% and 25.7%, CIRF 39.1% and 22.9%. Further treatments were performed respectively in 20.8% and in 23.4%. No anesthesia-related and Clavien-Dindo grade ≥ 3 complications occurred. No statistically significant difference was found in stone-free rates, CIRF and significant residual fragments rates, need for further procedures, operative time and complications between the two groups.
CONCLUSIONS: RIRS under SA seems feasible and effective for renal stones in day surgery. Results seem equivalent to RIRS under GA. SA can be considered for RIRS as an alternative to GA.


KEY WORDS: Day surgery - Kidney calculi - Spinal anesthesia - Ureteroscopy - Urolithiasis

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Publication History

Article first published online: March 28, 2018
Manuscript accepted: March 12, 2018
Manuscript revised: December 22, 2017
Manuscript received: March 13, 2017

Cite this article as

Bosio A, Dalmasso E, Alessandria E, Agosti S, Pizzuto G, Peretti D, et al. Retrograde intra-renal surgery (RIRS) under spinal anesthesia. The first large series. Minerva Urol Nefrol 2018 Mar 28. DOI: 10.23736/S0393-2249.18.02926-0

Corresponding author e-mail

andrea.bosio@unito.it